Surgical instrument with robotic and manual actuation features

ABSTRACT

In one embodiment of the invention, a robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site. The robotic surgical instrument may include a housing, a flow control system, a hollow tube, and one or more hose fittings. The housing to couple the instrument to a robotic arm. The flow control system mounted in the housing includes one or more controlled valves to control the flow of one or more fluids. The hollow tube has a first end mounted in the housing coupled to the flow control system. A second end of the hollow tube has one or more openings to allow the flow of fluids into and out of the surgical site. The hose fittings have a first end coupled to the flow control system and a second end to couple to hoses.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application is a continuation of and claims priority fromco-pending and commonly owned U.S. patent application Ser. No.11/341,155, entitled “ROBOTIC SURGICAL INSTRUMENTS WITH A FLUID FLOWCONTROL SYSTEM FOR IRRIGATION, ASPIRATION, AND BLOWING,” filed on Jan.27, 2006, which in turn claims priority from U.S. Provisional PatentApplication No. 60/696,482 entitled “IRRIGATION, ASPIRATION, AND BLOWINGFOR ROBOTIC SURGERY,” filed on Jun. 30, 2005, both of which are byinventors Paul Millman et al., and both of which are incorporated byreference herein in their entireties and for all purposes.

This patent application is also related to co-pending and commonly ownedU.S. patent application Ser. No. 11/341,004 filed Jan. 27, 2006; Ser.No. 13/443,852 filed Apr. 10, 2012, which is a continuation of andclaims priority from Ser. No. 11/454,359 filed Jun. 15, 2006; and Ser.No. 11/454,476 filed Jun. 15, 2006, all of which also claim priorityfrom U.S. Provisional Patent Application No. 60/696,482, and all ofwhich are also incorporated by reference herein in their entireties andfor all purposes.

FIELD

The embodiments of the invention relate generally to surgicalinstruments for robotic surgery. More particularly, the embodiments ofthe invention relate to irrigation/aspiration/blowing devices forsurgery.

BACKGROUND

During surgery on a patient, it is often desirable to irrigate asurgical site with a fluid, such as water, to clean or clear away blood,tissue, or other items obscuring the vision of a surgeon in the surgicalsite. Suction or aspiration in the surgical site may also be used tovacuum away blood, tissue, or other items obscuring the vision of thesurgeon in the surgical site.

Hand held surgical instruments have typically been used to provideirrigation and/or aspiration. The surgeon typically does not operate thehand held surgical instrument that provides irrigation and/oraspiration. An assistant surgeon or nurse handling such instruments mayprovide irrigation and/or aspiration of the surgical site. The surgeongives verbal instructions to the assistant surgeon or nurse to provideirrigation and/or aspiration of the surgical site. If the surgeon couldboth control the surgical instruments and the irrigation and aspirationof the surgical site, verbal instructions could be reduced and surgicalprocedures may be more efficient.

BRIEF SUMMARY

The embodiments of the invention are summarized by the claims thatfollow below.

BRIEF DESCRIPTIONS OF THE DRAWINGS

FIG. 1 is a block diagram of a robotic surgery system to performminimally invasive robotic surgical procedures using anirrigation/aspiration/blowing robotic surgical tool.

FIG. 2A is a perspective view of a robotic surgical manipulator with aplurality of robotic surgical arms at least one of which includes anirrigation/aspiration/blowing robotic surgical tool,

FIG. 2B is a perspective view of the robotic surgical arm including theirrigation/aspiration/blowing robotic surgical tool mounted thereto.

FIG. 2C illustrates mounting of the irrigation/aspiration/blowingrobotic surgical tool to an adapter of the robotic surgical arm of FIG.2B,

FIG. 2D illustrates a top view of the adapter of the robotic surgicalarm of FIG. 2C to which the irrigation/aspiration/blowing roboticsurgical tool may be mounted.

FIG. 3A is a perspective view of a robotic surgical master controlconsole.

FIG. 3B is a perspective view of an exemplary gimbaled device pivotallysupporting a touch sensitive handle for the robotic surgical mastercontrol console of FIG. 3A to control robotic surgical tools includingan irrigation/aspiration/blowing robotic surgical tool.

FIG. 3C is a cross-sectional view schematically illustrating mounting ofthe touch sensitive handle of FIG. 3B with sensors to sense gripping androtation of the handle to control robotic surgical tools, including anirrigation/aspiration/blowing robotic surgical tool.

FIG. 4A is a perspective view of an irrigation/aspiration/blowingrobotic surgical tool.

FIG. 4B is a hack side view of a portion of theirrigation/aspiration/blowing robotic surgical tool of FIG. 4A.

FIG. 5A is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool using two-way two-position valves.

FIG. 5B is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool using a three-way three-position valve.

FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowingrobotic surgical tool using a four-way four-position valve.

FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowingrobotic surgical tool using two-way two-position valves.

FIGS. 6A-6C are top views of rotationally actuated rotatable valves foruse with the irrigation/aspiration/blowing robotic surgical tool and therobotic surgical arm.

FIGS. 7A-7C are cross-sections of linearly actuated linear valves foruse with the irrigation/aspiration/blowing robotic surgical tool and therobotic surgical arm.

FIG. 8 is a top view of exemplary linear actuation of a rotatable valvefor use with the irrigation/aspiration/blowing robotic surgical tool andthe robotic surgical arm.

FIG. 9A is a top view of exemplary rotational actuation of a linearvalve for use with the irrigation/aspiration/blowing robotic surgicaltool and the robotic surgical arm with an optional manual push arm.

FIG. 9B is a top view of exemplary rotational actuation of a linearvalve for use with the irrigation/aspiration/blowing robotic surgicaltool and the robotic surgical arm with an optional manual push side-arm.

FIG. 10A is a top view to illustrate rotational actuation of a rotatablepinch valve for use with the irrigation/aspiration/blowing roboticsurgical tool and the robotic surgical arm.

FIG. 10B is a side view to illustrate linear actuation of a linear pinchvalve for use with the irrigation/aspiration/blowing robotic surgicaltool and the robotic surgical arm.

FIG. 11A is a top perspective view of an irrigation/aspiration/blowingrobotic surgical tool with cover removed to show a solid valve body.

FIG. 11B is a bottom exploded of the irrigation/aspiration/blowingrobotic surgical tool of FIG. 11A with the solid valve body.

FIG. 11C is a cross sectional view of the valve assembly with the solidvalve body in a closed position for the irrigation/aspiration/blowingrobotic surgical tool of FIG. 11A.

FIG. 11D is a cross sectional view of the valve assembly with the solidvalve body in an open position for the irrigation/aspiration/blowingrobotic surgical tool of FIG. 11A.

FIG. 11E is a top perspective view of an irrigation/aspiration/blowingrobotic surgical tool with a solid valve body including roboticallyactuated valves and manually actuated valves.

FIG. 12 is a top perspective view of an irrigation/aspiration/blowingrobotic surgical tool with cover removed to show the replaceable valves.

FIG. 13A is a top perspective view of an irrigation/aspiration/blowingrobotic surgical tool with cover removed to show rotatable pinch valves.

FIG. 13B is a top perspective view of the irrigation/aspiration/blowingrobotic surgical tool of FIG. 13A with cover in place to show manualhandles and a cleaning position of the handles.

FIG. 14 is a top view of an irrigation/aspiration/blowing roboticsurgical tool with cover removed to show the pinch valves andreplaceable tubing.

FIGS. 15A-15B are top views of irrigation/aspiration/blowing roboticsurgical tools with covers removed to respectively show three-way andfour-way couplers and replaceable tubing coupled thereto.

FIG. 16A is a side view of the touch sensitive handle of the diagram ofthe touch sensitive handle illustrated in FIG. 3B for the roboticsurgical master control console of FIG. 3A.

FIGS. 16B-16D are side views of grip positions of the touch sensitivehandle to control the irrigation/aspiration/blowing robotic surgicaltool in a surgical site.

FIG. 17 is a graph showing exemplary control of irrigation andaspiration using grip control of the touch sensitive handlecorresponding to the side views of the touch sensitive handleillustrated in FIGS. 16B-16D.

FIG. 18A is a top perspective view of the irrigation/aspiration/blowingrobotic surgical tool with light emitting diodes at the distal end toprovide user feedback.

FIG. 18B is a top perspective view of the irrigation/aspiration/blowingrobotic surgical tool with a light pipe along side the flow tube that iscoupled to a light emitting diode at the proximal end to provide userfeedback.

FIG. 18C is a top perspective view of the irrigation/aspiration/blowingrobotic surgical tool with a sliding sleeve around the flow tube that ismoved to reveal a scale at the distal end to provide user feedback bymechanical means.

FIG. 18D is a top perspective view of the irrigation/aspiration/blowingrobotic surgical tool with a rotational sleeve around the flow tube thatrotates to reveal a scale at the distal end and provide user feedback bymechanical means.

FIG. 18E is a perspective view of a first tip for theirrigation/aspiration/blowing robotic surgical tool of FIG. 18D with arotational sleeve around the flow tube that rotates to reveal a scaleand provide user feedback.

FIG. 18F is a perspective view of a second tip for theirrigation/aspiration/blowing robotic surgical tool of FIG. 18D with arotational sleeve around the flow tube that rotates to reveal a scaleand provide user feedback.

FIG. 18G is a perspective view of a third tip for theirrigation/aspiration/blowing robotic surgical tool of FIG. 18D with arotational sleeve around the flow tube that rotates to reveal a scaleand provide user feedback.

FIG. 19 is a viewer of the robotic surgical master control console ofFIG. 3A with an icon overlaid onto the displayed images to provide userfeedback as to the control of the irrigation/aspiration/blowing roboticsurgical tool.

FIG. 20A illustrates a viewer of the master control console of FIG. 3Awith an icon overlay in a single side to provide user feedback as to thecontrol of the irrigation/aspiration/blowing robotic surgical tool.

FIG. 20B illustrates a viewer of the master control console of FIG. 3Awith an icon overlay in both left and right sides to providethree-dimensional user feedback as to the control of theirrigation/aspiration/blowing robotic surgical tool.

DETAILED DESCRIPTION

In the following detailed description of the embodiments of theinvention, numerous specific details are set forth in order to provide athorough understanding of the embodiments of the invention. However, itwill be obvious to one skilled in the art that the embodiments of theinvention may be practiced without these specific details. In otherinstances well known methods, procedures, components, and circuits havenot been described in detail so as not to unnecessarily obscure aspectsof the embodiments of the invention.

The embodiments of the invention include a method, apparatus, and systemfor robotically controlled irrigation/aspiration/blowing of an internalor external surgical area or site where robotic surgery is beingperformed. Aspiration may also be referred to as suction.

In one embodiment of the invention a robotic surgical system is providedincluding a master control console, a surgical manipulator, a firsthose, and a first pump. The master control console is used to generatecontrol signals to cause one or more fluids to flow into or out of asurgical site. The surgical manipulator is coupled to the master controlconsole to receive the control signals. The surgical manipulatorincludes at least one robotic arm to manipulate at least one roboticsurgical instrument, and a surgical instrument coupled to the roboticarm. The surgical manipulator controls the surgical instrument inresponse to the control signals to control the flow of the one or morefluids into or out of the surgical site. The surgical instrument has afirst robotically controlled valve responsive to the surgicalmanipulator and a hollow tube having an opening at one end to direct theflow of one or more fluids in the surgical site. The first roboticallycontrolled valve has a first port and a second port and the hollow tubehas a first end coupled to the second port of the first roboticallycontrolled valve. The first hose has a first end coupled to the firstport of the first robotically controlled valve. The first hosetransports a first fluid to the first robotically controlled valve. Thefirst pump has a port coupled to a second end of the first hose. Thefirst pump pumps a first fluid through the first hose to the firstrobotically controlled valve of the surgical instrument.

In another embodiment of the invention, a robotic surgical system isprovided including a master control console, a surgical manipulator, anda first pump. The master control console generates control signals tocause a fluid to flow into or out of a surgical site. The surgicalmanipulator is coupled to the master control console to receive thecontrol signals. The surgical manipulator includes at least one roboticarm to manipulate at least one surgical instrument. A surgicalinstrument is coupled to the robotic arm to control the flow of a fluidinto or out of the surgical site. The surgical instrument has a firsthose, a first robotically controlled pinch valve, and a hollow tube. Thefirst hose is flexible and has a first end and a second end. The firstrobotically controlled pinch valve receives the first hose. The firstrobotically controlled pinch valve squeezes and pinches closed the firsthose and releases and opens the first hose. The hollow tube has a firstend to couple to the first end of the first hose. The first pump has aport coupled to the second end of the first hose.

In another embodiment of the invention, a method is provided. The methodincludes generating a first control signal to control a robotic surgicalinstrument; coupling the first control signal into the robotic surgicalinstrument; and opening a first valve in the robotic surgical instrumentto flow a first fluid over a surgical site in response to the firstcontrol signal.

In another embodiment of the invention, another method is provided. Themethod includes mounting an irrigation-aspiration robotic surgicalinstrument to a robotic arm of a robotic surgical manipulator; couplingat least one hose from the irrigation-aspiration robotic surgicalinstrument to at least one pump; inserting a tip of a hollow tube of theirrigation- aspiration robotic surgical instrument into a patient near asurgical site; controlling a flow of a fluid between the surgical siteand the irrigation-aspiration robotic surgical instrument; andmonitoring a level of the flow of the fluid between the surgical siteand the irrigation-aspiration robotic surgical instrument.

In yet another embodiment of the invention, a robotic surgicalinstrument is provided for the control of flows of one or more fluidsinto and out of a surgical site. The robotic surgical instrumentincludes a housing, a flow control system mounted in the housing, ahollow tube having a first end mounted in the housing, and one or morehose fittings having a first end coupled to the flow control system. Thehousing can couple the robotic surgical instrument to a robotic arm. Theflow control system includes one or more controlled valves to controlthe flow of one or more fluids through the robotic surgical instrument.The first end of the hollow tube couples to the flow control system. Theone or more hose fittings have a second end to respectively couple toone or more hoses.

In still another embodiment of the invention, another robotic surgicalinstrument is provided for the control of flows of one or more fluidsinto and out of a surgical site.

The robotic surgical instrument includes an interface base, a hollowtube having a proximal end mounted to the interface base, a three-waycoupler having a first port coupled to the proximal end of the hollowtube, a first robotically controlled valve coupled to the interfacebase, and a second robotically controlled valve coupled to the interfacebase. The interface base can mechanically and electrically couple to anend of a robotic arm. The hollow tube further has a distal end forplacement in a surgical site to allow the flow of fluids into and out ofa surgical site. The three-way coupler further has a second port and athird port to couple the first port, the second port, and the third porttogether to flow fluids there-between. The first robotically controlledvalve having a first port to couple to a first hose and a second portcoupled to the second port of the three-way coupler. The firstrobotically controlled valve controls the flows of a first fluid. Thesecond robotically controlled valve having a first port to couple to asecond hose and a second port coupled to the third port of the three-waycoupler. The second robotically controlled valve controls the flows of asecond fluid.

Robotic surgery generally involves the use of a robot manipulator thathas multiple robotic manipulator arms. One or more of the roboticmanipulator arms often support a surgical tool which may be articulated(such as jaws, scissors, graspers, needle holders, micro dissectors,staple appliers, tackers, suction/irrigation tools, clip appliers, orthe like) or non- articulated (such as cutting blades, cautery probes,irrigators, catheters, suction orifices, or the like). One or more ofthe robotic manipulator arms are often used to support a surgical imagecapture device such as an endoscope (which may be any of a variety ofstructures such as a laparoscope, an arthroscope, a hysteroscope, or thelike), or, optionally, some other imaging modality (such as ultrasound,fluoroscopy, magnetic resonance imaging, or the like). Typically, thearms will support at least two surgical tools corresponding to the twohands of a surgeon and one image capture device.

Robotic surgery may be used to perform a wide variety of surgicalprocedures, including but not limited to open surgery, neurosurgicalprocedures (such as stereotaxy), endoscopic procedures (such aslaparoscopy, arthroscopy, thoracoscopy), and the like.

Robotic Surgical System

Referring now to FIG. 1, a block diagram of a robotic surgery system 100is illustrated to perform minimally invasive robotic surgical proceduresusing an irrigation/aspiration/blowing (IAB) robotic surgical tool 101A.The irrigation/aspiration/blowing robotic surgical tool 101A is arobotic endoscopic surgical instrument that is manipulated by a slavedrobotic manipulator and remotely controlled by control signals receivedfrom a master control console. In contrast, manual endoscopic surgicalinstruments are directly controlled by hand.

A user or operator O (generally a surgeon) performs a minimally invasivesurgical procedure on patient P by manipulating input devices at amaster control console 150. A computer 151 of the console 150 directsmovement of robotically controlled endoscopic surgical instruments(generally numbered 101), effecting movement of the instruments using arobotic surgical manipulator 152. The robotic surgical manipulator 152may also be referred to as robotic patient-side cart system or simply asa cart. The robotic surgical manipulator 152 has one or more roboticarms 153. Typically, the robotic surgical manipulator 152 includes atleast three robotic manipulator arms 153 supported by linkages, with acentral arm supporting an endoscopic camera and the robotic arms 153 toleft and right of center supporting tissue manipulation tools and theirrigation/aspiration/blowing robotic surgical tool 101A such as therobotic manipulator arm 153C.

An assistant A may assist in pre-positioning of the robotic surgicalmanipulator 152 relative to patient P as well as swapping tools orinstruments 101 for alternative tool structures, and the like, whileviewing the internal surgical site via an assistant's display 154. Theimage of the internal surgical site shown to A by the assistant'sdisplay 154 and operator O by surgeon's console 150 is provided by oneof the surgical instruments 101 supported by the robotic surgicalmanipulator 152.

Generally, the robotic arms 153 of robotic surgical manipulator 152include a positioning portion and a driven portion. The positioningportion of the robotic surgical manipulator 152 remains in a fixedconfiguration during surgery while manipulating tissue. The drivenportion of the robotic surgical manipulator 152 is actively articulatedunder the direction of the operator O generating control signals at thesurgeon's console 150 during surgery. The actively driven portion of thearms 153 is herein referred to as an end effector 158. The positioningportion of the robotic arms 153 that are in a fixed configuration duringsurgery may be referred to as positioning linkage and/or “set-up joint”156, 156′.

To support the irrigation/aspiration/blowing robotic surgical tool 101A,the robotic surgical system may further include one or more pumps102A-102C, one or more inline filters 104A-104C, and one or more hoses106A-106C. For irrigation, the pump 102A is a sterile fluid pump and maybe an intravenous (IV) pump with an input port or inlet coupled to an IVbag 108 through a hose 106D. The output port or outlet of the pump 1102Amay couple to the robotic surgical instrument 101A directly or throughthe inline filter 104A. The IV bag 108 may have a pressure cuff. Foraspiration, the pump 102B is a vacuum pump 102B with an output port 110exhausting to atmosphere and an input port coupling to a suctioncanister 105 through the inline filter 104B. In an alternate embodimentof the invention, suction may be provided to rooms at a wall inlet toisolate the noise of the vacuum pump 102B. For blowing, the pump 102C isa gas compressor with an input port coupled to a source of gas 111, suchas oxygen or air, and an output port coupled to the instrument 101Athrough the inline filter 104C.

The one or more hoses 106A-106C may be joined together along a portionof their length and into one end to couple to the instrument 101A forease of coupling and to readily manage a plurality of hoses as one unitat the robotic manipulator 152. Towards the opposite end, the one ormore hoses 106A-106C may separate to couple to the inline filters, thepumps, the canister 105, or other pipe fittings as the case may be.

In one embodiment of the invention, the master control console 150 maycontrol the one or more pumps 102A-102C and any valves thereat in orderto control fluid flow between the pumps and the instrument 101A into andout of the surgical site. One or more control signal lines 109A-109C maycouple between the computer 151 and the one or more pumps 102A-102C andany valves thereat in order that they may be controlled by controlsignals from the master control console 150. In which case, the hoses106A-106C may simply couple to a coupler within the instrument 101A asis discussed further below with reference to FIGS. 15A-15B.

Referring now to FIG. 2A, a perspective view of the robotic surgicalmanipulator 152 is illustrated. The robotic surgical manipulator 152 hasone or more robotic surgical arms 153. The robotic arm 153C includes anirrigation/aspiration/blowing robotic surgical tool 101A coupled theretoat the end effector 158. The robotic surgical manipulator 152 furtherincludes a base 202 from which the robotic surgical instruments 101 maybe supported. More specifically, the robotic surgical instruments 101are each supported by the positioning linkage 156 and the end effector158 of the arms 153. It should be noted that these linkage structuresare here illustrated with protective covers 206,208 extending over muchof the robotic arms, it should be understood that these protectivecovers 206,208 are optional, and may be limited in size or entirelyeliminated in some embodiments to minimize the inertia that ismanipulated by the servomechanism, and to limit the overall weight ofrobotic surgical manipulator 152.

The robotic surgical manipulator 152 generally has dimensions suitablefor transporting between operating rooms. It typically can fit throughstandard operating room doors and onto standard hospital elevators. Therobotic surgical manipulator 152 may have a weight and a wheel (or othertransportation) system that allows the cart to be positioned adjacent anoperating table by a single attendant. The robotic surgical manipulator152 may be sufficiently stable during transport to avoid tipping, and toeasily withstand overturning moments that may be imposed at the ends ofthe robotic arms during use.

Referring now to FIG. 2B, a perspective view of the robotic surgical arm153C is illustrated including the irrigation/aspiration/blowing roboticsurgical tool 101 mounted thereto. Each of the robotic manipulating arms153 preferably includes a linkage 212 that constrains the movement ofthe surgical tool 101 mounted thereto. More specifically, linkage 212includes rigid links coupled together by rotational joints in aparallelogram arrangement so that the robotic surgical tool 101A rotatesaround a point 215 in space. At the point 215, the robotic arm can pivotthe robotic surgical tool 101A about a pitch axis 215A and a yaw axis215B. The pitch and yaw axes intersect at the point 215, which isaligned along a shaft 216 of robotic surgical tool 101A. In the case ofthe IAB robotic surgical tool 101A, the shaft is a hollow tube as isfurther discussed below.

The robotic arm provides further degrees of freedom of movement to therobotic surgical tool 101A. Along an insertion axis 215C, parallel tothe central axis of the shaft 216 of the robotic surgical tool 101A, therobotic surgical tool 101A may slide into and out from a surgical site.The robotic surgical tool 101A can also rotate about the insertion axis215C. As the robotic surgical tool 101A slides along or rotates aboutthe insertion axis 215C, the center point 215 is relatively fixed withrespect to the base 218. That is, the entire robotic arm is generallymoved in order to maintain or re-position back to the center point 215.

The linkage 212 of the robotic arm 153 is driven by a series of motors217 therein in response to commands from a processor or computer. Themotors 217 in the robotic arm are also used to rotate and/or pivot therobotic surgical tool 101A at the point 215 around the axes 215A-215C.If a robotic surgical tool 101 further has end effectors to bearticulated or actuated, still other motors 217 in the robotic arm maybe used to do so. A flow control system in the IAB robotic surgical tool101A may be actuated by these other motors in the robotic arm 153.However, alternative means may also be used to actuate or control theflow control system in the IAB robotic surgical tool 101A. Additionally,the motion provided by the motors 217 may be mechanically transferred toa different location such as by using pulleys, cables, gears, links,cams, cam followers, and the like or other known means of transfer, suchas pneumatics, hydraulics, or electronics.

For endoscopic surgical procedures, the end effector 158 of the roboticarm 153 is often fitted with a hollow cannula 219. The shaft or tube ofthe robotic surgical tool 101 may be inserted into the hollow cannula219. The cannula 219, which may be releasably coupled to the robotic arm153, supports the shaft or tube of the robotic surgical tool 101,preferably allowing the tool to rotate around the axis 215C and moveaxially through the central bore of the cannula along the axis 215C.

The robotic surgical tools 101 are generally sterile structures, oftenbeing sterilizable and/or being provided in hermetically sealed packagesfor use. As the robotic surgical tools 101 will be removed and replacedrepeatedly during many procedures, a tool holder could potentially beexposed to contamination if the interface directly engages the toolholder. To avoid contamination to a tool holder and possible crosscontamination between patients, an adaptor for coupling to roboticsurgical tools 101 is provided in a robotic arm of the robotic surgicalmanipulator.

Referring now to FIGS. 2C, 2D, and 4B, the mounting of theirrigation/aspiration/blowing robotic surgical tool 101A to an adapter228 of the robotic surgical arm is now briefly described.

The robotic surgical arm 153 may include an adapter 228 to which the IABrobotic surgical tool 101A or other surgical tool 101 may be mounted.FIG. 2D illustrates a front side of an exemplary adapter 228. The frontside of the adaptor 128 is generally referred to as a tool side 230 andthe opposite side is generally referred to as a holder side (not shown).

FIG. 4B illustrates a back side of an exemplary IAB robotic surgicaltool 400 as the IAB surgical robotic tool 101A. The robotic surgicaltool 400 includes an exemplary mountable housing 401 including aninterface base 412 that can be coupled to the adapter 228. The interfacebase 412 and the adapter 228 may be electrically and mechanicallycoupled together to actuate the flow control system of the IAB roboticsurgical tool 101A. Rotatably coupled to the interface base 412 are oneor more rotatable receiving members 418. Each of the one or morerotatable receiving members 418 includes a pair of pins 422A and 422Bgenerally referred to as pins 422. Pin 422A is located closer to thecenter of each rotatable receive member 418 than pin 422B. The one ormore rotatable receiving members 418 can mechanically couplerespectively to one or more rotatable drivers 234 of the adapter 228.The robotic surgical tool 101A may further include release levers 416 torelease it from the adapter 228.

The interface base 412 may further include one or more electricalcontacts or pins 424 to electrically couple to electrical connector 242of the adapter 228. The interface base 412 may further include a printedcircuit board 425 and one or more integrated circuits 426 coupledthereto and to the one or more pins 424. The one or more integratedcircuits 426 may be used to identify the type of robotic surgical toolcoupled to the robotic arm, so that it may be properly controlled by themaster control console 150.

The adapter 228 includes one or more rotatable drivers 234 rotatablycoupled to a floating plate 236. The rotatable drivers 234 areresiliently mounted to the floating plate 236 by resilient radialmembers which extend into a circumferential indentation about therotatable drivers. The rotatable drivers 234 can move axially relativeto floating plate 236 by deflection of these resilient structures.

The floating plate 236 has a limited range of movement relative to thesurrounding adaptor structure normal to the major surfaces of theadaptor. Axial movement of the floating plate helps decouple therotatable drivers 234 from a robotic surgical tool 101 when its releaselevers 416 are actuated.

The one or more rotatable drivers 234 of the adapter 228 maymechanically couple to a part of the surgical tools 101. Each of therotatable drivers 234 may include one or more openings 240 to receiveprotrusions or pins 422 of rotatable receiving members 418 of therobotic surgical tools 101. The openings 240 in the rotatable drivers234 are configured to accurately align with the rotatable receivingelements 418 of the surgical tools 101.

The inner pins 422A and the outer pins 422B of the rotatable receivingelements 418 respectively align with the opening 240A and the opening240B in each rotatable driver. The pins 422A and openings 240A are atdiffering distances from the axis of rotation than the pins 422B andopenings 240B so as to ensure that rotatable drivers 234 and therotatable receiving elements 418 are not aligned 180 degrees out ofphase from their intended position. Additionally, each of the openings240 in the rotatable drivers may be slightly radially elongated so as tofittingly receive the pins in the circumferential orientation. Thisallows the pins 422 to slide radially within the openings 240 andaccommodate some axial misalignment between the tool and the adapter228, while minimizing any angular misalignment and backlash between therotatable drivers 234 and the rotatable receiving elements 418.Additionally, the interaction between pins 422 and openings 240 helpsrestrain the robotic surgical tool 101 in the engaged position with theadapter 228 until the release levers 416 along the sides of the housing401 push on the floating plate 236 axially from the interface so as torelease the tool 101.

When disposed in a first axial position (away from the tool side 230)the rotatable drivers are free to rotate without angular limitation. Theone or more rotatable drivers 234 may rotate clockwise orcounter-clockwise to further actuate the systems and tools of therobotic surgical instruments 101. However, as the rotatable drivers moveaxially toward the tool side 230, tabs (extending radially from therotatable drivers) may laterally engage detents on the floating platesso as to limit the angular rotation of the rotatable drivers about theiraxes. This limited rotation can be used to help engage the rotatabledrivers the rotating members of the tool as the pins 422 may push therotatable bodies into the limited rotation position until the pins arealigned with (and slide into) the openings 140 in the rotatable drivers.

While rotatable drivers 234 are described here, other types of driversor actuators may be provided in the adapter 228 to actuate systems ortools of the robotic surgical instruments 101. The adapter 228 furtherincludes an electrical connector 242 to electrically couple to surgicalinstruments 101.

The mounting of robotic surgical tool 101A to the adapter 228 generallyincludes inserting the tip or distal end of the shaft or hollow tube ofthe robotic surgical tool through the cannula 219 and sliding theinterface base 412 into engagement with the adapter 228, as illustratedin FIG. 2C. A lip 232 on the tool side 230 of the adaptor 228 slidablyreceives the laterally extending portions of the interface base 412 ofthe robotic surgical tool. A catch 244 of adapter 228 may latch onto theback end of the interface base 412 to hold the tool 101A in position.The protrusions or pins 422 extending from the one or more rotatablemembers 418 of the robotic surgical tool couple into the holes 240 inthe rotatable drivers 234 of the adapter 228.

The range of motion of the rotatable receiving elements 418 in therobotic surgical tool may be limited. To complete the mechanicalcoupling between the rotatable drivers of the adapter and the rotatablereceiving elements 418, the operator O at the surgical master controlconsole 150 may turn the rotatable drivers in one direction from center,turn the rotatable drivers in a second direction opposite the first, andthen return the rotatable drivers to center. Further, to ensure that thepins 422 enter openings 240 of adapter 228, the adapter 228 and tool101A mounted thereto may be moved along the axis 215C. The adapter 228and tool 101A mounted thereto may be moved to an initial position sothat the tip or distal end of the shaft or hollow tube is disposedwithin the cannula 219.

To dismount and remove the robotic surgical tool 101A, the releaselevers 416 may be squeezed pushing out on the mountable housing 401 torelease the pins 422 from the holes 240 and the catch 244 from the backend of the interface base. The mountable housing 401 is then pulled upto slide the interface base 412 up and out from the adapter 228. Themountable housing 401 is continually pulled up to remove the tip ordistal end of the shaft or hollow tube out from the cannula 219. Afterthe robotic surgical tool 101A is dismounted, another robotic surgicaltool may be mounted in its place, including a new or freshly sterilizedIAB robotic surgical tool 101A.

As previously discussed, the robotic surgical tool 101A may include oneor more integrated circuits 426 to identify the type of robotic surgicaltool coupled to the robotic arm, such that it may be properly controlledby the master control console 150. However, the robotic surgical systemmay determine whether or not the robotic surgical tool is compatible ornot, prior to its use.

The system verifies that the tool is of the type which may be used withthe robotic surgical system 100. The one or more integrated circuits 426may signal to the computer 151 in the master control console 150 dataregarding compatibility and tool-type to determine compatibility as wellas control information. One of the integrated circuits 426 may include anon-volatile memory to store and read out data regarding systemcompatibility,the tool-type and the control information. In an exemplaryembodiment, the data read from the memory includes a character stringindicating tool compatibility with the robotic surgical system 100.Additionally, the data from the tool memory will often include atool-type to signal to the master control console how it is to becontrolled. In some cases, the data will also include tool calibrationinformation. The data may be provided in response to a request signalfrom the computer 151.

Tool-type data will generally indicate what kind of tool has beenattached in a tool change operation. For example, the tool-type datamight indicate that an IAB robotic surgical instrument 101A has beenmounted to the robotic arm. The tool-type data may include informationon wrist axis geometries, tool strengths, grip force, the range ofmotion of each joint, singularities in the joint motion space, themaximum force to be applied via the rotatable receiving elements 418,the tool transmission system characteristics including informationregarding the coupling of rotatable receiving elements 418 to actuationor articulation of a system within the robotic surgical instrument.

Instead of storing all of the tool-type date in the one or moreintegrated circuits 426, most of the tool-type data may optionally bestored in memory or a hard drive of the computer 151 in the roboticsurgical system 100. An identifier may be stored in the one or moreintegrated circuits 426 to signal the computer 151 to read the relevantportions of data in a look up table store in the memory or the harddrive of the computer. The tool-type data in the look-up table may beloaded into a memory of computer 151 by the manufacturer of the roboticsurgical system 100. The look-up table may be stored in a flash memory,EEPROM, or other type of non-volatile memory. As a new tool-type isprovided, the manufacturer can revise the look-up table to accommodatethe new tool-specific information. It should be recognized that the useof tools which are not compatible with the robotic surgery system, forexample, which do not have the appropriate tool-type data in aninformation table, could result in inadequate robotic control overrobotic surgical tool by the computer 151 and the operator O.

In addition to the tool-type data, tool specific information may bestored in the integrated circuit 426, such as for reconfiguring theprogramming of computer 151 to control the tool. There may becalibration information, such an offset, to correct a misalignment inthe robotic surgical tool. The calibration information may be factoredinto the overall control of the robotic surgical tool. The storing ofsuch calibration information can be used to overcome minor mechanicalinconsistencies between tools of a single type. For example, thetool-type data including the tool-specific data may be used to generateappropriate coordinate transformations and servo drive signals tomanipulate the robotic arm and rotate the rotatable drivers 234.

Additionally, some robotic surgical tools have a limited life span. Toollife and cumulative tool use information may also be stored on the toolmemory and used by the computer to determine if the tool is still safefor use. Total tool life may be measured by clock time, by procedure, bythe number of times the tool has been loaded onto a holder, and in otherways specific to the type of tool. Tool life data is preferably storedin the memory of the tool using an irreversible writing process.

Referring now to FIG. 3A, a perspective view of a robotic surgicalmaster control console 150 is illustrated. The master control console150 of the robotic surgical system 100 includes the computer 151, abinocular viewer 312, an arm support 314, a microphone 315, a pair ofcontrol input wrists and control input arms in a workspace 316, a speechrecognizer 317, foot pedals 3118 (including foot pedals 318A-318B), anda viewing sensor 320.

The computer 151 may include one or microprocessors 302 to executeinstructions and a storage device 304 to store software with executableinstructions that may be used to generate control signals to control therobotic surgical system 100. The master control console 150 generatesthe control signals to control the fluid flows through the embodimentsof the IAB robotic surgical instruments into and out of a surgical site.

The viewer 312 has at least one display where images of a surgical sitemay be viewed to perform minimally invasive surgery. As discussedfurther below, the viewer 312 may be used to provide user-feedback tothe operator O as to the control of the fluid flow through the IABrobotic surgical instruments into and out of a surgical site.

The arm support 314 can be used to rest the elbows or forearms of theoperator O (typically a surgeon) while gripping touch sensitive handles325 (see FIGS. 3B-3C), one in each hand, of the pair of control inputwrists 352 in the workspace 316 to generate control signals. The touchsensitive handles 325 are positioned in the workspace 316 disposedbeyond the arm support 314 and below the viewer 312.

When using the master control console, the operator O typically sits ina chair, moves his or her head into alignment with the binocular viewer312, and grips the touch sensitive handles 325 of the control inputwrists 352, one in each hand, while resting their forearms against thearm support 314. This allows the touch sensitive handles to be movedeasily in the control space 316 in both position and orientation togenerate control signals.

Additionally, the operator O can use his feet to control the foot-pedalsto change the configuration of the surgical system and generateadditional control signals to control robotic surgical instruments.

To ensure that the operator is viewing the surgical site whencontrolling the robotic surgical tools 101, the master control console150 may include the viewing sensor 320 disposed adjacent the binoculardisplay 312. When the system operator aligns his or her eyes with thebinocular eye pieces of the display 312 to view a stereoscopic image ofthe surgical worksite, the operator's head sets off the viewing sensor320 to enable the control of the robotic surgical tools 101. When theoperator's head is removed the area of the display 312, the viewingsensor 320 can disable or stop generating new control signals inresponse to movements of the touch sensitive handles in order to holdthe state of the robotic surgical tools.

The computer 151 with its microprocessors 302 interprets movements andactuation of the touch sensitive handles 325 (and other inputs from theoperator O or other personnel) to generate control signals to controlthe robotic surgical instruments 101 in the surgical worksite. In oneembodiment of the invention, the computer 151 and the viewer 312 map thesurgical worksite into the controller workspace 316 so it feels andappears to the operator that the touch sensitive handles 325 are workingover surgical worksite.

Referring now to FIG. 3B, a perspective view of a control input wrist352 with a touch sensitive handle 325 is illustrated. The control inputwrist 352 is a gimbaled device that pivotally supports the touchsensitive handle 325 of the master control console 150 to generatecontrol signals that are used to control the robotic surgicalmanipulator 1152 and the robotic surgical tools 101, including an IABrobotic surgical tool 101A. A pair of control input wrists 352 aresupported by a pair of control input arms in the workspace 316 of themaster control console 150.

The control input wrist includes first, second, and third gimbal members362, 364, and 366. The third gimbal member 366 is rotationally mountedto a control input arm (not shown) to rotate about an axis D. As furthershown in FIG. 3B, the second gimbal member 364 rotates with respect tothe third gimbal member 366 about an axis E. The first gimbal member 362rotates with respect to the second gimbal member 364 about an axis F.The handle 325 rotates with respect to the first gimbal member 362 aboutan axis G.

The touch sensitive handle 325 includes a tubular support structure 351,a first grip 350A, and a second grip 350B. The first grip and the secondgrip are supported at one end by the structure 351. The touch sensitivehandle 325 can be rotated about axis G illustrated in FIGS. 3B-3C. Thegrips 350A, 350B can be squeezed or pinched together about the tubularstructure 351. The “pinching” or grasping degree of freedom in the gripsis indicated by arrows Ha,Hb in FIG. 3B and arrows H in FIG. 3C.

The touch sensitive handle 325 is rotatably supported by the firstgimbal member 362 by means of a rotational joint 356 g. The first gimbalmember 362 is in turn, rotatably supported by the second gimbal member364 by means of the rotational joint 356 f. Similarly, the second gimbalmember 364 is rotatably supported by the third gimbal member 366 using arotational joint 356 d. In this manner, the control wrist allows thetouch sensitive handle 325 to be moved and oriented in the workspace 316using three degrees of freedom,

The movements in the gimbals of the control wrist 352 to reorient thetouch sensitive handle in space can be translated into control signalsto control the robotic surgical manipulator 152 and the robotic surgicaltools 101. In particular, the rotational motion of the touch sensitivehandle 325 about axis G in FIGS. 3B-3C may be used to control the flowof fluids through the IAB robotic surgical tools.

The movements in the grips 350A,350B of the touch sensitive handle 325can also be translated into control signals to control the roboticsurgical manipulator 152 and the robotic surgical tools 101. Inparticular, the squeezing motion of the grips 350A, 350B over theirfreedom of movement indicated by arrows Ha, Hb or H, may be used tocontrol the flow of fluids through the IAB robotic surgical tools.

In embodiments of the invention, one or a combination of both therotational motion of the touch sensitive handle 325 and the squeezingmotion of the grips 350A, 350B may be used to control the flow of fluidsthrough the IAB robotic surgical tools. For example, the rotationalmotion of the touch sensitive handle 325 may be used for the control ofirrigation while the squeezing motion of the grips 350A, 350B may beused for controlling suction in a surgical site.

To sense the movements in the touch sensitive handle and generatecontrols signals for the IAB robotic surgical tool, sensors can bemounted in the handle 325 as well as the gimbal member 362 of thecontrol input wrist 352. Exemplary sensors may be a Hall effecttransducer, a potentiometer, an encoder, or the like.

Referring now to FIG. 3C, a cross-sectional view of the touch sensitivehandle 325 and gimbal member 362 of the control input wrist 352 isillustrated. FIG. 3C provides an example as to how the touch sensitivehandle 325 can be mounted to the control input wrist 352 to sense thegripping and rotation of the handle to control robotic surgical tools101, including IAB robotic surgical tools 101A.

As illustrated in FIG. 3C, the exemplary gimbal member 362 includesbeveled gears 368 a, 368 b which can couple the rotational motion of thetouch sensitive handle 325 to a roll sensor 370. The roll sensor 370 mayuse a potentiometer or encoder 370 b included in a roll motor 370 a tosense the rotation. Alternatively, a separate roll sensor, such as apotentiometer, may be directly coupled to the shaft 380 to sense therotation of the touch sensitive handle. In any case, a roll sensorsenses the roll motion of the touch sensitive handle 325 and generatescontrol signals in response thereto to control the robotic surgicaltools 101. The control of IAB robotic surgical tools 101A using the rollmotion of the touch sensitive handle 325 is discussed below withreference to FIG. 16A.

To sense a squeezing motion in the grips 350A, 350B of the touchsensitive handle 325, a remote sensing assembly 386 may be included bythe gimbal member 362. The first and second grips 350A, 350B are adaptedto be squeezed together by a hand of an operator O so as to define avariable grip separation. The grip separation may be determined as afunction of a variable grip angle with an axis or as a function of avariable grip separation distance, or the like. Alternative handleactuations, such as movement of a thumbwheel or knob may also beprovided in the handle to control the robotic surgical instruments 101.

In the exemplary embodiment, the remote sensor assembly 386 includes acircuit board 394 on which a first and a second Hall effect sensors,HE1, HE2 are mounted. A magnet 396 is disposed distally beyond thecircuit board 394 and the Hall effect sensors. A magnetic mass 398 isaxially coupled to the proximally oriented surface 390 of a push rod384. Thus, the magnetic mass 398 moves (as shown by Arrow J) with thepush rod 384 and varies the magnetic field at the Hall effect sensors inresponse actuation of the grips 350A, 350B.

To translate the squeezing action of the grips 350A, 350B to the sensor386, the gimbal member 362 includes a push rod 384 within the tubularhandle structure 351. Each of the grips 350A, 350B pivot about arespective pivot 334a, 334b in the tubular handle structure 351. Urginglinks 335 a, 335 b respectively couple between the grips 350A, 350B anda first end of the push rod 384. The squeezing action of the grips 350A,350B is translated into a linear motion on the push rod 384 by means ofurging links 335 a, 335 b as shown by arrow A in FIG. 3C. A second endof the push rod 384 couples to the sensor 386. As discussed previously,the magnetic mass 398 is axially coupled to the surface 390 of the pushrod 384 in order to sense the linear motion in the push rod and thesqueezing motion of the grips 350A, 350B.

A biasing mechanism such as spring 392 applies a force against thesqueezing motion of the grips to return them to full open when the gripsare released. The biasing spring 392 may be a linear or non-linearelastic device biasing against the depression of grips 350A, 350B, e.g.,a single or multiple element assembly including springs or other elasticmembers. For example, spring 392 may comprise a concentric dual springassembly whereby one spring provides a “softer” bias response as thegrips 350A, 350B are initially depressed, and a second spring provides asuperimposed “firm” bias response as the grips 350A, 350B approach afully depressed state. Such a non-linear bias may provide a pseudoforce-feedback to the operator.

It should be noted that a wide variety of alternative sensingarrangements may be used to translate the mechanical actuation of thetouch sensitive handle and control input wrist into control signals.While Hall effect sensors are included in the exemplary embodiment,alternative embodiments may include encoders, potentiometers, or avariety of alternative optical, electrical, magnetic, or other sensingstructures.

Irrigation/Aspiration/Blowing Robotic Surgical Instrument

A number of embodiments of irrigation/aspiration/blowing (IAB) roboticsurgical tools that can be mounted to a robotic arm in a roboticsurgical system are now described.

Referring to FIGS. 4A-4B, an irrigation/aspiration/blowing (IAB) roboticsurgical tool or instrument 400 is illustrated in greater detail thanthat of instrument 101A. In one embodiment of the invention, the IABrobotic surgical instrument 400 has an interface that is backwardcompatible to the adapter 228 that is typically used for other types ofrobotic surgical instruments. In yet another embodiment of theinvention, the IAB robotic surgical instrument 400 has a reusableinstrument housing with modular valve components that are disposable. Inyet another embodiment of the invention, the entire IAB robotic surgicalinstrument 400 is disposable.

The IAB robotic surgical instrument 400 includes a mountable housing 401at a proximal end and a hollow tube 404 coupled together as shown inFIG. 4A. The mountable housing 401 maybe a reusable housing includingsome reusable components therein. The mountable housing 401 is backwardcompatible and includes an interface base 412 that can couple to theadapter 228 to which other surgical tools may also couple. The mountablehousing 401 may further include one or more tube fittings 410A-410C, acover 414, and one or more release levers 416.

The hollow tube 404 is elongated and has an opening 424 at its tip 406,the distal end of the instrument 400. The hollow tube 404 may also bereferred to as a hollow instrument shaft or a hollow probe. The hollowtube 404 may be reusable or disposable. The hollow tube 404 maybecoupled to the interface base 412 for additional support. Alternative,the hollow tube 404 may couple directly to a modular disposable valvesubassembly and avoid coupling to the interface base such that it too isdisposable.

In one embodiment of the invention, the hollow tube 404 is a hollowcircular cylindrical shape. Fluids (e.g., gas, liquid, with or withoutsolids) may flow in the hollow tube 404 and into or out from a surgicalsite through the opening 424 at the tip 406. The hollow tube 404 mayfurther include one or more smaller openings 422 around itscircumference substantially near the tip 406 to further allow fluid toflow into and out of a surgical site. The diameter of the opening 424may be substantially same as the inner diameter of the tube 404. In oneembodiment of the invention, the diameter of the hollow tube 404 may bebetween 5 mm and 8 mm. The hollow tube 404 may be formed out of metal,plastic or other rigid material that can be hollow to allow fluid toflow therein while being positioned within a patient's body at asurgical site or over a surgical area.

The interface base 412 is used to mount the instrument 400 to a roboticarm of a surgical robotic manipulator. The interface base 412 bothmechanically and electrically couples the IAB robotic surgicalinstrument 400 to a robotic arm of the surgical robotic manipulator 152.The release levers 416 are located at the sides of the mountable housingand may be used to release the robotic surgical instrument 400 from arobotic arm.

A first end of the one or more tube fittings 410A-410C may respectivelycouple to the one or more hoses 106A-106C, respectively. The one or moretube fittings 410A-410C may be barb fittings, luer fittings, or othertypes of hose or tube fittings. A second end of the one or more tubefittings 410A-410C couples to a flow control system 417 within themountable housing 401. In some embodiments of the invention, the one ormore hoses 106A-106C may directly couple to the flow control systemwithout the one or more tube fittings 410A-410C. The end of the hollowtube 404 opposite the tip 406, also couples to the flow control system417.

The flow control system 417 controls the flow of fluids, including anysolids that may be transported by the fluid, between the surgical siteand the one or more hoses 106A-106C through the IAB robotic surgicalinstrument 400. The flow control system 417 may include one or morevalves of a valve subassembly to control the flow of fluids and anysolids that may be transported by the fluid. Note that a fluid may be aliquid, a gas, a vacuum, or any combination thereof. The flow controlsystem 417 may be controlled by control signals generated by an operatorO at the master control console 150 to control the fluid flow throughthe IAB robotic surgical instrument 400. In addition to robotic control,a number of embodiments of the invention include an optional manualactuation of the valves of the IAB robotic surgical instrument 400. Inwhich case, either an assistant A can manually operate the flow controlsystem 417 and control the fluid flow or the operator O at the mastercontrol console 150 may robotically operate the flow control system 417to control the fluid flow through the IAB robotic surgical instrument400. The operator O at the master control console 150 can position theIAB robotic surgical instrument 400 where the operator wants it withinthe surgical site. Then, to free up the operator's hands to perform someother task at the master control console, the IAB robotic surgicalinstrument 400 may be controlled manually by an assistant, remainingattached to a robotic arm. The operator can then give verbalinstructions to the assistant to manually control theirrigation/suction/blowing in the surgical site selected by theoperator.

The cover 414 covers over to protect the flow control system 417 such asa valve subassembly from damage and to maintain a sterile surgicalenvironment during surgery. As the surgical instrument 400 is usedduring an operation or surgery at a surgical site of human patient, itis important that its components be sterilized.

As body fluids of a human patient will be flowing through the surgicalinstrument 400 during use, it may be desirable to re-sterilize the IABrobotic surgical tool for reuse. However, it may be difficult tore-sterilize portions of the flow control system 417, such as valves,within the IAB robotic surgical tool 400. Thus, portions of the flowcontrol system 417 may be replaced instead of sterilized after usage. Ifcomponents forming the IAB robotic surgical instrument 400 arerelatively inexpensive, the IAB robotic surgical instrument 400 may bediscarded in its entirety instead of re-sterilzing or replacingcomponents.

FIG. 4B illustrates a back side view of a portion of the IAB roboticsurgical tool 400, some elements of which were previously discussed. Inparticular, the interface base 412 is illustrated with rotatablereceiving elements 418 rotatably coupled thereto. The rotatablereceiving elements 418 provide a mechanical coupling to the rotatabledrivers 234 and drive motors mounted of the robotic surgical manipulator152. Each of the rotatable receiving elements 418 include a pair of pins422 extending from a surface thereof. An inner pin 422A is closer to anaxis of rotation of each rotatable receiving elements 418 than an outerpin 422B, which helps to ensure positive angular alignment of therotatable receiving elements 418. In one embodiment of the invention,the rotatable receiving elements 418 are disk shaped and may be referredto as rotatable disks.

The interface base 412 further includes an array of electricalconnecting pins 424 and one or more integrated circuits 426 coupled to aprinted circuit board 425 within the mountable housing 401. As theinterface base 412 is backward compatible to the adapter 228, it maybemechanically actuated by pre-existing driver motors found in the roboticsurgical manipulator 152. While the interface base 412 has beendescribed herein with reference to mechanical and electrical couplingelements, it should be understood that other modalities maybe used,including infrared coupling, magnetic coupling, inductive coupling, orthe like.

Referring now to FIGS. 5A-5D, schematic flow diagrams of roboticsurgical tools 500A-500D are respectively illustrated to provideirrigation, suction, blowing, or any combination thereof within asurgical site.

FIG. 5A is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool 500A that uses a pair of valves mounted within a housing501A. The tool 500A includes the hollow tube 504, a valve subassembly506, a three-way coupler 508, and tube fittings 509A-509B. The tubefittings 509A-509B may have an irrigation hose 106A and a suction hose106B respectively coupled thereto.

The valve subassembly 506 includes a first two-way two-position valve510A and a second two-way two-position valve 510B. After use, the valvesubassembly 506 may be removed and replaced by a new sterilized valvesubassembly for reuse of the tool 500A. The valves are a component ofthe tool that is more difficult to clean and sterilize for reuse.

Each of the two way valves 510A-510B includes two ports. A first portcouples to the three-way coupler 508 while a second port couples to thefittings 509A or 509B, respectively. A three-way coupler 508 includesthree ports one of which is coupled to the hollow tube 504. The secondport of the three-way coupler couples to a port of the valve 510A. Athird port of the three-way coupler 508 couples to a port of the valve510B.

A fluid may flow in or out of the hollow tube 504 as illustrated by thedouble-headed arrow near the tip. Either valve 510A or 510B may be openso that a fluid may flow through the hollow tube 504. With valve 510Bopen and valve 510A substantially closed, a suction may be applied nearthe tip of the surgical instrument 500A so that a surgical site may beaspirated. With valve 510B substantially closed and valve 510A open, aliquid may flow through the surgical instrument 500A out through thehollow tube 504 into a surgical site so that it may be irrigated. Theliquid is coupled to the surgical instrument 500A by the hose 106A.

FIG. 5B is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool 500B that uses a single valve mounted within a housing501B to provide irrigation, or aspiration. The surgical instrument 500Bincludes a single three-way valve 516 with three ports, the hollow tube504, and the tube fittings 509A-509B. The three way coupler 508 is notneeded.

The three-way valve 516 has three ports. A first port of the three-wayvalve couples to the proximal end of the hollow tube 504. A second portcouples to the tube fitting 509A that may couple to the hose 106A. Athird port of the valve 516 couples to the tube fitting 509B that may inturn couple to hose 106B.

The three-way valve 516 has three-positions of operation. In a closedposition, the valve is completely shut off so that no fluid flowsthrough the hollow tube 504. In a second position suction is shut off,the first port and the second port of the valve couple together suchthat the surgical site may be irrigated by a liquid flowing throughvalve 516 and into the hollow tube 504. In a third position irrigationis shut off, the first port and the third port of the valve coupletogether such that a vacuum or a suction may flow through valve 516 anda surgical site may be aspirated at the tip of the hollow tube 504.

FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowingrobotic surgical tool 500C that uses a single valve mounted within ahousing 501C to provide irrigation, aspiration or blowing. The surgicalinstrument 500C includes a single four-way four position valve 526, thehollow tube 504, and the tube fittings 509A-509B coupled together asillustrated in the mountable housing 501C. A four way coupler 508 is notneeded.

The single four-way valve 526 includes four ports. A first port of thefour-way valve 526 couples to the proximal end of the hollow tube 504. Asecond port of the valve 526 couples to one end of the tube fitting509A. A third port of the valve 526 couples to an end of the tubefitting 509B. A fourth port of the valve 526 couples to an end of thetube fitting 509C. Hoses 106A-106C may respectively couple to the tubefittings 509A-509C. In this manner three of the four ports of valve 526may receive a liquid for irrigation, a vacuum for suction and apressurized gas for blowing, respectively.

The four-way valve 526 has four positions of operation. In a closedposition, the valve is completely shut off so that no fluid flowsthrough the hollow tube 504. In a second position suction/blowing areshut off, the first port and the second port of the valve coupletogether such that the surgical site may be irrigated by a liquidflowing through valve 526 and into the hollow tube 504. In a thirdposition irrigation/suction are shut off, the first port and the thirdport of the valve couple together such that a pressurized gas may flowthrough valve 516 and out through the tip of the hollow tube 504 to blowa surgical site with a pressurized gas. In a fourth positionirrigation/blowing are shut off, the first port and the fourth port ofthe valve couple together such that a vacuum may provide suction throughthe valve 516 and the hollow tube 504 to a surgical site to removefluids and solids transported therein at the tip of the hollow tube 504.

FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowingrobotic surgical tool 500D that uses three two-way valves in a valvesubassembly mounted within a housing 501D to provide irrigation,aspiration or blowing. The robotic surgical instrument 500D includes avalve subassembly 536, a four-way coupler 538, the hollow tube 504, andthe tube fittings 509A-509C. The tube fittings 509A-509C may couple tothe hoses 106A-106C, respectively.

In place of the four-way valve 526 illustrated in FIG. 5C, the valvesubassembly 536 includes three two-way two-position valves 510A-510C ofa valve subassembly 536 in conjunction with a four-way coupler 538. Incomparison with the tool 500A of FIG. 5A, a third two-way valve 510C isprovided so that a third fluid may flow into and out of the hollow tube504. In this case, a pressurized gas may be supplied by hose 106C, flowthrough valve 510C when opened, flow through the four way coupler 538,and into the hollow tube 504 to blow a pressurized gas near the surgicalsite.

Each of the two way two position valves 510A-510C includes two ports. Afirst port of each couples to respective ports of the four-way coupler538 while a second port of each couples to the fittings 509A, 509B or509C, respectively. The four-way coupler 538 includes four ports one ofwhich is coupled to the hollow tube 504. The second port of the four-waycoupler 538 couples to a port of the valve 510A. A third port of thefour-way coupler 538 couples to a port of the valve 510B. A fourth portof the four-way coupler 538 couples to a port of the valve 510C.

Valve subassembly 536 may be replaceable with a sterile component whilethe other elements mounted in the housing 501D may be separatelysterilized and reused with a new valve subassembly 536.

Various types of valves may be used as part of the flow control system417 in the IAB robotic surgical instrument 400, 101A to control the flowof fluids to provide irrigation, aspiration, or blowing. For example, alinear motion type of valve (“linear valve”) may be used such as aspool-type valve, a trumpet-type valve, a piston-type valve, apoppet-type valve, or a sliding-plate-type valve. Alternatively, arotational motion type of valve (“rotatable valve”) may be used such asa ball-type valve, a screw-type valve, a gate-type valve, a disc-typevalve, a cock- type valve, a globe-type valve, or a rotary-plate-typevalve. Additionally, the various types of valves within the IAB roboticsurgical instrument may be actuated in different ways by the roboticsurgical manipulator 152. While three-way and two-way valves have beenseparately shown and described, any mixed combination of one or moretwo-way valves and one or more three-way valves, or other multi-portvalve, may be used within an IAB robotic surgical instrument withdifferent types of couplers to provide a flow control system therein.For example, an IAB robotic surgical instrument may include a three-wayvalve 516 for gas pressure and suction and a two-way valve 510A forirrigation by a liquid coupled to a three-way coupler 508, which is inturn coupled to the tube 504.

Moreover, the valves used in the flow control system may beautomatically returned to a closed position so that no fluid flowsthrough the IAB robotic surgical tool when it is dismounted from therobotic arm or when the modular valve assembly is not mounted in thehousing of the tool. That is, the valves may be spring loaded by aspring to return to a closed or fully off position when they are notactuated.

FIGS. 6A-6C, 7A-7C, 8, 9 and 10A-10B illustrate some of the varioustypes of valves, various types of actuation means, and various types ofautomatic return means that may be used to control the flow of fluidsthrough the robotic surgical instrument and into the surgical site. Itis understood that other types of valves, actuation means, and automaticreturn means may be used to provide flow control for a flow controlsystem of an IAB robotic surgical tool.

Referring now to FIGS. 6A-6C, rotational actuators to actuate rotatablevalves are illustrated for use with the irrigation/aspiration/blowingrobotic surgical tool and the robotic surgical arm.

In FIG. 6A, the rotatable receiving element 418A is directly coupled tothe rotatable valve 604A. As the rotatable receiving element 418A isrotated, a shaft of the rotatable valve rotates to a different positionin order to open or close the valve and control the flow of fluids. Foractuation, the rotatable receiving element 418A couples to the rotatabledriver 234 of the adapter 228 in the robotic arm. The pins 422A-422B ofthe rotatable receiving element 418A couple into the respective openings240A-240B of the adapter 228. A coil spring 606 may be used to returnthe rotatable valve 604A to a closed or shut off position when therobotic surgical tool 101A is dismounted from the robotic arm.

In FIG. 6B, a rotatable receiving element 418B rotatably couples to therotatable valve 604B through a gearing provided by the gears 610-611.The rotatable receiving element 418B similarly couples to the rotatabledriver 234. The rotatable receiving element 418B includes the gear 610which also may be referred to as a driving gear 610. Valve 604B includesthe pinion gear 6111 coupled to a shaft 602 of the rotatable valve inorder to rotate the valve from one position to another. The gearing maybe use to reduce or increase the rotation in the driver gear 610 torotate the valve. The rotatable receiving element 418B may furtherinclude the coil spring 606 to return the three-way four position valve604B to a shut off position. The rotatable valve 604B is a three-wayvalve including three ports and has three positions.

In FIG. 6C, the rotatable receiving element 418C is linked to therotatable valve 604C by means of a linkage 620. The rotatable receivingelement 418C includes a drive wheel with a notch 622 to receive a distalend of the linkage 620. The rotatable valve 604C is a three-way threeposition valve. The rotatable receiving element 418C may move the valve604C into one of three positions. In position 620A, the valve may beshut off so that no fluid flows through the robotic surgical tool 101A,400. In position 620B, a first fluid may flow between a first port and asecond port. In position 620C, a second fluid may flow between the firstport and a third port.

To change positions of the valve using the linkage 620, the rotatablereceiving element 418C may be moved counter clockwise, while the valverotates clockwise. If the rotatable receiving element 418C movesclockwise, the linkage 620 causes the valve to rotate counter clockwise.To actuate the rotatable valve, the rotatable receiving element 418Ccouples to the rotatable driver 234 by means of the pins 422A-422Bcoupling into the opening 240A-240B respectively.

FIGS. 7A-7C illustrate the linear actuation of linear motion valves thatmay be used in the flow control system 417 of IAB robotic surgicaltools. The dashed lines shown in FIGS. 7A-7C illustrate a dividing linebetween the robotic surgical tool 400, 101A and actuation in the roboticsurgical arm 153.

In FIG. 7A, a push rod 702 is linearly actuated in the robotic arm 153.One end of the push rod 702 pushes on a button 703 of a linear motiontrumpet valve 704A to move a plunger 705 therein. The trumpet valve 704Ais a two-way two-position valve. The plunger 705 in its closed positionblocks the first and second ports of the trumpet valve 704A. When thevalve is linearly pushed open, a spring 706 is compressed and theplunger moves to a position. 705′ such that the first and second portsare open to pass a fluid.

The push rod 702 may be linearly actuated in robotic arm in a number ofways including, but not limited to, pneumatically, hydraulically,electromechanically, or electrically. For example, a solenoid 701 may beused to linearly actuate the push rod 702 to linearly move the valve704A to an open position. When the push rod 702 is not actuated, theforce of the spring 706 may push back on the push rod 702 and return theplunger of the valve to a closed plunger position 705 to shut off thefirst and second ports and stop a flow of a fluid. The spring 706 mayalso retain the plunger of the valve in a closed plunger position 705 toshut off the first and second ports when the IAB robotic surgical toolis dismounted.

In FIG. 7B, a spool valve 704B linearly moves in response to a magneticforce generated by the electromagnet 710 in the robotic arm 153. Theelectromagnet 710 may be formed out of coil of wire 711 wrapped around amagnetic core 712. When no electromagnetic field is generated by theelectromagnet 710, a spring 706 keeps the spool 715 in a closed positionblocking the first and second ports of the spool valve 704B. To actuatethe spool valve, the electromagnet 710 is actuated to pull the spool 715in a linear motion into position 715′ so that the center hourglassportion of the spool 715 is coincident with the first and second portsto allow fluid to flow through the valve 70413. Spring 706 is compressedwith the spool in position 715′ such that when the electromagnetic forceof the electromagnet 710 is released the spring 706 pushes back on thespool 715 to close off the valve 704B.

In FIG. 7C, a three-way spool valve 704C is electrically actuated by therobotic arm 153 to move the spool 725 with a linear motion. Electricalcontacts 242 in the robotic arm 153 couple to the pins 424 of therobotic surgical tool 400, 101A. The three-way valve 704C includes thespool 725, three ports, a first spring 706A at a first end, and a secondspring 706B at a second end, a first wire coil 710A at the first end,and a second wire coil 710B at the second end current in the wires 721Amay flow through the coil 710A to attract the spool 725 towards thefirst end of the valve so that the ports 726 and 728 of the valve arecoincident with the center hourglass portion of the spool to allow fluidto flow there-between. To shut off the valve, the current flow in thewires 721A is turned off and the spool 725 is pushed back into theclosed position by the force of spring 706A. Springs 706A-706B maintainthe spool in the center position shutting off the three ports in thevalve from each other. By providing a current in the wires 721B and thecoil 720B, the spool 725 is moved towards the second end and compressesthe spring 706B. This allows the center hourglass portion of the spool725 to coincide with the second port 727 and the third port 728 to allowa fluid to flow there-between. To shut off the valve, the current flowin the wires 721B is turned off and the spring 706B pushes the spool 725back to its closed position.

Referring now to FIG. 8, a linear actuation is transformed into arotational actuation for a rotatable valve by a rack and pinion gearsystem. When activated, a push rod 702 linearly pushes against a button803 of the rack 801 in order to linearly move its teeth 810 and providethe initial linear actuation. The teeth 810 of the rack 801 are meshedwith the pinion gear 811 to transform the initial linear actuation ofthe push rod into a rotational actuation. The pinion gear is coupled toa shaft 802 of the rotatable valve 804. As the teeth of the rack 801linearly move, the pinion gear 811 transforms the linear motion into arotational motion in order to rotate the rotatable valve 804 betweenopen and closed positions to control the fluid flow.

A spring may be coupled between an end of the rack 801 and a stop inorder to linearly push on the rack and rotate and maintain the valve ina closed position when the IAB robotic surgical tool is dismounted.

In addition to being robotically controlled from the master controlconsole 150, the valves of the flow control system 417 of the IABrobotic surgical tools may also be manually controlled. Manual actuatorsmay be provided that extend external to the housing so that a user'shand may open and/or close the valves.

Referring now to FIGS. 9A-9B, a rotational actuation is transformed intolinear actuation by a cam and cam follower system for actuation of alinear motion trumpet valve 704A. Trumpet valve 704A illustrated inFIGS. 9A-9B operates similarly to trumpet valve 704A of FIG. 7A but witha cam follower 903 in place of the button 703 to better couple to therotating cam 902. Additionally, the cam follower 903 of FIG. 9A mayfurther include a manual push arm 913 that may extend for a top side ofa housing of the IAB robotic surgical tools for manual operation of thetrumpet valve 704A. The cam follower 903 of FIG. 9B may further includea manual push side arm 923 that may extend for a side of a housing ofthe IAB robotic surgical tools for manual operation of the trumpet valve704A.

The rotatable receiving element 418D of the IAB robotic surgical toolsis coupled to the cam 902. For robotic control from the master controlconsole 150, the rotatable receiving element 418D couples to therotatable driver 234 by means of the pins 422A-422B within the openings240A-240B, respectively.

The cam 902 includes a cam lobe 904 that pushes on the cam follower 903to a position 903′ so that the plunger 705 is moved to an open position705′. In the open position 705′, the plunger allows the first and secondports to couple together and allow a fluid to flow there-between. As thecam rotates to move the cam lobe to a different position so that the camfollower can move back to its original position 903, the spring 706pushes on the plunger 705 to move it back into the closed position toclose the valve 704A.

The cam 902 may rotate clockwise or counterclockwise so that the camfollower transforms a rotational motion into a linear motion to open andclose the valve 704A. In this manner, a rotational actuation within therobotic surgical tool 400, 101A may be converted to linear actuation andactuate a linear motion valve, such as the trumpet valve 704A. A coilspring may be coupled around the shaft of the cam 901 in order to rotateit so that the valve can close when the IAB robotic surgical tool isdismounted.

With the cam 902 rotated to a position so that the valve 704A is closed,the valve may be manually operated. To manually operate valve 704A, auser pushes on the manual push arms 913, 923 extending from the housing.With the manual push arms 913, 923 being coupled to the cam follower903, the force applied thereto manually forces open the valve 704A. Thisdecouples the cam follower 903 from the cam 902. To close the valve704A, a user releases the force applied to the manual push arms 913, 923which allows the spring 706 to push back out the plunger 705 into aclosed position and shut off the valve.

Referring now to FIGS. 10A-10B, pinch valves 1004A-1004B for use in theflow control system of IAB robotic surgical tools are illustrated. Thepinch valves 1004A-1004B are used to pinch closed a hose 1002, 1002′ tocontrol the flow of fluids.

In FIG. 10A, a rotary pinch valve 1004A is illustrated to pinch closed ahose 1002 and can be rotated to release and open the hose 1002. Withoutthe hose 1002 pinched off, a fluid is allowed to flow therein andthrough the IAB robotic surgical tools. The rotary pinch valve 1004Apinches the hose 1002 closed against a backstop 1005 to shut off theflow of fluids. The hose 1002 may be a silicon rubber hose that isflexible in order that it may be readily pinched off and stop the fluidflow therein and flex back when released.

The rotary pinch valve 1004A is coupled to a shaft of the rotatablereceiving element 418E to receive a rotational actuation. The rotatablereceiving element 418E may couple to the rotatable driver 234 in asimilar fashion as previously described with pins 422A-422B insertedinto the respective openings 240A-240B.

The rotary pinch valve 1004A includes a rotatable pinch arm 1020 and apinch roller 1022 coupled to the distal end of the rotatable pinch arm1020. The rotary pinch valve 1004A may further include a spring 1006coupled to the rotatable receiving element 418E in order to bias thepinch valve to a closed position and pinch off the hose when thesurgical tool 101A, 400 is dismounted.

In the closed position, the pinch roller 1022 pinches off the hose 1002against the backstop 1005. In rotating the pinch valve 1004A and therotatable pinch arm from the closed position to a position 1020′, thepressure against the hose 1002 is released such that it flexes open andallows fluid to flow therein.

In FIG. 10B, a linear pinch valve 1004B is illustrated to pinch closed ahose 1002′. The linear pinch valve 1004B can be moved linearly torelease and open the hose 1002′. Without the hose 1002′ pinched off, afluid is allowed to flow therein and through the IAB robotic surgicaltools. The linear pinch valve 1004B pinches the hose 1002′ closedagainst a backstop 1015 to shut off the flow of fluids. The hose 1002′may be a silicon rubber hose that is flexible in order that it may bereadily pinched off and stop the fluid flow therein and flex back whenreleased.

A push rod 702 may be provided in the robotic arm 153 to provide linearactuation of the linear pinch valve 1004B. The push rod 702 pushes on abutton 1013 to a position 1013″, compressing a spring 1016, and linearlymoving the linear pinch valve 1004B and a linear pinch arm 1030 toposition 1030′ to release the hose 1002 from the backstop 1015. With thelinear pinch arm 1030 in the open position 1030′, the linear pinch valveis open and fluid can flow within the hose 1002′. Upon releasing thelinear force provided by the push rod 702 within the robotic arm 153,the spring 1016 forces back the linear pinch arm 1030 of the linearpinch valve 1030 to squeeze the hose 1002 against the backstop 1015. Inthis manner, a linear actuating motion of the push rod 702 can activatea linear pinch valve 1004B.

FIGS. 11A-15B illustrate exemplary embodiments of IAB robotic surgicaltools including varying types of flow control systems.

Referring now to FIGS. 11A-11E, irrigation/aspiration/blowing roboticsurgical tools having a flow control system with a solid valve body arenow discussed.

FIG. 11A illustrates a top perspective view of an IAB robotic surgicaltool 1100A, with its cover removed to show the flow control system 417therein. The IAB robotic surgical tool 1100A employs a solid valve body1101. The solid valve body 1101 is a three-dimensional solid body thatincludes hollow passages with open ports therein and a pair of valveopenings to receive a pair of rotatable valves 1104A-1104B. In oneembodiment of the invention, the solid valve body 1101 is a polyhedronshaped solid body.

With a solid valve body, the flow control system 417 of the IAB roboticsurgical tool 1100A is relatively inexpensive to manufacture such thatthe flow control system 417 may be discarded after use, instead ofcleaned or sterilized. The remaining components of the tool 1100A, maybe cleaned and re-sterilized. Alternatively, the IAB robotic surgicaltool 1100A is also relatively inexpensive to manufacture such that itmay be discarded in its entirety after usage.

A first port of the solid valve body 1101 couples to the proximal end ofthe hollow tube 404. Second and third ports of the solid valve body 1101may couple to the hose fittings 410A-410B. The hose fittings 410A-410Bmay respectively couple to hoses 1106A-106B. The solid valve body 1.101includes a three-way passage 11.06 coupled between the proximal end ofthe hollow tube 404 and first ports of rotatable valves 1104A-1104B. Thesolid valve body 1101 further includes passages 1108A-1108B coupledbetween second ports of the rotatable valves 1104A-1104B and the hosefittings 410A-410B, respectively. The rotatable valves 1104A-1104B aretwo-way two-position valves and each have an open flow channel that canbe rotated and switched open or closed between the ports to therespective passages 1108A-1108B and the ports to the three-way passage1106.

Although a third valve and a third set of passages are not illustratedin FIG. 11A, it is understood that it may be provided to provide flowcontrol for a third type of fluid.

The hollow tube 404 is mechanically supported in the mountable housingby having an end coupled into the first port of the solid valve body1101. The hollow tube 404 maybe further supported mechanically by beinginserted into a bushing that is supported within the collar 1102 of theinterface base 412. As previously discussed, the hollow tube 404 has anopening 424 at its tip 406. The hollow tube 404 may further haveopenings around its circumference near its tip 406.

The solid valve body 1101 may be fitted to the interface base 412 sothat it is readily replaceable. The hollow tube 404 may be fitted with aquick release fitting to the solid valve body 11011 so that it can bereadily re-sterilized and reused.

Referring now to FIG. 11B, a bottom exploded view of the IAB roboticsurgical tool 1100A is illustrated. As illustrated by FIG. 11B, thesolid valve body 1101 includes valve openings 1109A-1109B to receive therotatable valves 1104A-1104B, respectively. The valve openings1109A-1109B in the solid valve body may include threads or rings toallow the rotatable valves 1104A-1104B to rotate in a fixed axialposition with respect to the passages 1106, and 1108A-1108B.

Coupled to one end of a cylindrical shaft 1105 of each of the rotatablevalves 1104A-1104B is a rotatable receiving element 418 with pins422A-422B. The rotatable receiving element 418 of the rotatable valves1104A-1104B may further include a tab 1114 to abut against a stop withinthe interface base 412.

Elements of the rotatable valves 1104A-1104B may be molded together asone piece to further lower the cost of manufacture of the flow controlsystem. As valves 1104A-1104B are substantially similar, a furtherdetailed description of valve 1104A is only provided with valves1104A-1104B being collectively referred to as valves 1104.

In the cylindrical shaft 1105 of the valves 1104 is the flow channel1110. The flow channel 1110 of the rotatable valves 1104 may be aslanted opening through the condrical shaft. The flow channel 1110 ofthe rotatable valves 1104 may be a slanted opening through thecylindrical shaft. Wrapped around the cylindrical shaft are one or moreseals 1112 to seal off the flow channel 1110 within the valve body 1101.A slanted seal 1113 may be provided above the slanted opening of theflow channel 1110. In an alternate embodiment of the invention, anadditional slanted seal 1113 may be provided below the slanted openingof the flow channel 1110. The cylindrical shaft 1105 has circumferentialchannels to respectively receive a portion of the one or more seals1112. The cylindrical shaft 1105 has one or more slanted channels in itscylindrical surface to respectively receive a portion of the one or moreslanted seals 1113. The channels in the shaft 11.05 keep the seals inposition as the valve is moved.

Referring now to FIG. 11C, a cross section of one of the rotatablevalves 1104 is illustrated in a closed position. As discussedpreviously, the rotatable valve 1104 includes the cylindrical shaft 1105coupled at one end to the rotatable receiving element 418.

The cylindrical shaft 1105 includes the flow channel 1110. The flowchannel 1110 has a first port 1110A at one end and a second port 1110Bat a second end. As discussed previously, the flow channel 1110 may beslanted from the first port 1110A to the second port 1110B. As valve1104 is in a closed position in FIG. 11C, neither the first port 1110Anor the second port 1110E of the flow channel 1110 matches the portsinto the passages 1106 or 1108A, 1108B. The cylindrical shaft 1105further includes one or more seals 1112 near top and bottom portions toseal off the flow channel 1110 in the solid body 1101. The cylindricalshaft 1105 further includes the slanted seal 1113 between a top seal1112 and the slanted flow channel 1110 to further seal the rotatablevalve within the solid body 1101.

The slanted seal 1113 around the cylindrical shaft 1105 allows forrelaxed tolerances between the rotatable valve 1104 and the solid valvebody 1101. In particular, the slanted seal 1113 allows for a largerradial gap between the cylindrical shaft 1105 of the valve 1104 and thesolid valve body 1101 while maintaining a leak-less seal. While the topand bottom seals 1112 seal the valve 1404 with respect to the valvebody, the slanted seal 1113 seals the flow of fluids through the channel1110. The slanted seal 1113 seals the flow of fluids through the channel1110 over the range of positions of the valve 1104, from a fully closedposition to a fully open position. The slanted seal 1113 particularlyprevents leakage when the valve 1104 is in the closed position.

In an alternate embodiment of the invention, the channel 1110 in thecylindrical shaft 1105 is replaced by narrowing the center diameterportion of the cylindrical shaft 1105 between the slanted seal 1113 andthe bottom seal 1112, such as into an hour glass shape, to form achannel for fluid flow when the valve 1104 is moved from a closedposition. In this case, the slanted seal 1113 forms an end portion ofthe channel,

The hollow tube 404 couples to a port of the three-way passage 1106. Thehose fittings 410A, 4110B couple to the passages 1108A, 1108B,respectively. The hose fittings 410A, 4108 and the hollow tube 404 maybe press fitted into the solid valve body 1101 or have threads to bescrewed into and mate with threads in passages 1106, 1108A, 1108B of thesolid valve body 1101.

Referring now to FIG. 11D, a cross section of one of the rotatablevalves 1104 is illustrated in an open position. With the rotatable valve1104 in an open position, a fluid can flow between the hollow tube 404and one of the hose fittings 410A, 410B by way of the passages in thesolid valve body 1101 and the flow channel 1110.

In comparison with FIG. 11C, the flow channel 1110 in the cylindricalshaft 1105 is reoriented to a position where its first port 1110Amatches a port of the three-way passage 1106 and its second port 1110Ematches a port of the passage 1108A, 1108B. In this manner, a fluid canflow from the hollow tube into the three way passage 1106, through theflow channel 1110, into the passage 1108A, 1108B and out of the hosefitting 410A, 4108. Alternatively, a fluid can flow from the hosefitting 410A, 41.013, into the passage 1108A, 1108B, through the flowchannel 1110, into the three way passage 1.106 and out from the hollowtube 404.

FIGS. 11C-11D illustrate one or more seals 1112 near top and bottomportions of the shaft 1105 and the slanted seal 1113 in parallel withthe slanted flow channel 1110 to seal the rotatable valves 1004A-1104Bin the solid body 1101.

The rotatable valves 1104A and 1104B may operate in the same rotationaldirection or in opposite rotational directions. That is, each rotatablevalve may operate to open in a clockwise direction or a counterclockwisedirection. Alternatively, rotatable valve 1104A may open using acounterclockwise rotation while rotatable valve 1104B opens using aclockwise rotation, for example.

With a solid valve body 1101 and one piece rotatable valves 1104, theflow control system 417 can be made relatively inexpensive such that itcan be readily discarded with or without other components of thesurgical tool 1100A.

As discussed previously, the valves of the flow control system 4117 ofthe IAB robotic surgical tools may also be manually controlled withmanual actuators. Additional manually controlled valves may also beprovided in parallel with robotically controlled valves in the flowcontrol system in order to both manually and robotically control thefluid flows through an IAB robotic surgical instrument. Manual actuatorsare coupled to the manually controlled valves to extend external to thehousing of the IAB robotic surgical tools so that a user's hand may openand/or close the valves.

Referring now to FIG. 11E, the solid valve body 1101 has been modifiedto solid valve body 1101′ that includes manually controlled valves1124A-1124B in parallel with the respective robotically controlledvalves 1104A-1104B in order that the fluid flows through the IAB roboticsurgical instrument 1100B may be controlled manually by hand androbotically from a master control console 150. The manually controlledvalves 1124A-1124B are trumpet valves, a type of valve such asillustrated in FIG. 7A and previously described. The valves 1124A-1124Beach include a button 1125 on top that extends out from the housing 401through the cover 414 (not illustrated in FIG. 11E), such as illustratedin FIG. 13B. However, the trumpet valves 1124A-1124B are two-way twoposition valves that are linearly actuated by a finger or hand pushingon the button to open the valve and allow fluid to flow. As in valve704A, each of the manually controlled valves 1124A-1124B includes aspring 706 to return the valve to a closed position when the force isreleased from the button 1125, (see FIG. 7A). The button 1125 is similarto the button 703 of the valve 704A illustrated in FIG. 7A.

To support the valves 1124A-1124B, the two way passages 1108A-1108B andthe three way passage 11106 in the solid valve body 1101 illustrated inFIG. 111A are modified respectively into three way passages1108A′-1108B′ and a five way passage 1106′ of the solid valve body 1101′illustrated in FIG. 11E. The five way passage 1106′ includes one or moreparallel passages 1126 to a port of the valves 1124A-1124B. That is, thefive way passage 1106′ has a first port to couple to the tube 404, asecond port and a third port to respectively couple to valves1104A,1104B, and a fourth port and a fifth port to respectively coupleto the valves 1124A-1124B. The three way passages 1108A′-1108B′ eachinclude a side passage 1128 to a port of the valves 1124A-1124B. Thethree way passage 1108A′ has a first port to couple to the valve 1104A,a second port to couple to the valve 1124A, and a third port to coupleto the hose fitting 410A. The three way passage 1108B′ has a first portto couple to the valve 1104B, a second port to couple to the valve1124B, and a third port to couple to the hose fitting 410B. The solidvalve body 1101′ further includes an additional pair of valve openingsto receive the spring 706 and the plunger 705 of the trumpet valve 704A.Additional seals may be provided around the shaft between the plunger705 and the buttons 703, 1125.

Otherwise, the modified solid valve body 1101′, including the structureand function of the valves 1104A-1104B, is similar to that of the solidvalve body 1101 illustrated by FIGS. 11A-11D and described previously.

Referring now to FIG. 12, a top perspective view of an IAB roboticsurgical tool 1200 is illustrated with its cover over the mountablehousing removed. The IAB robotic surgical tool 1200 includes a modularvalve subassembly 1201. After being used once, the modular valveassembly 1201 and coupling hoses 1208A-1208B are readily replaceablewith new used components. The remaining portion of the tool 1200 may bere-sterilized and then reused with a new modular valve assembly 1201 andcoupling hoses 1208A-1028B. The modular valve subassembly 1201 ismountable to and dismountable from the interface base 412. A base 1211of the modular valve subassembly 1201 may press fit into place to mountthe valve subassembly to the interface base 412. The base 1211 of themodular valve subassembly 1201 includes recesses for rigid attachment ofthe ports of the valves 1204A-1204B and the ports of the hose fittings410A-410B. Hoses 106A-106B may be coupled to ends of the hose fittings410A-410B. The control and actuation of the rotatable valves 1204A-1204Bwas previously described with reference to FIG. 6A and the rotatablevalve 604A.

The modular valve subassembly includes a first rotatable valve 1204A anda second rotatable valve 1204B. Each of the valves 1204A-1204B aretwo-way, two-position valves having a pair of ports. The valves104A-104B may be trumpet valves, ball cock style valves, or otherrotatable type of valve used to control the flow of gases or fluids.Coupled to the first ports of each valve 1204A-1204B are the hosefittings 410A-410B, respectively. Coupled to a second port of each ofthe valves 1204A-1204B are first ends of the respective coupling hoses1208A-1208B. Second ends of the hoses 1208A-1208B respectively couple toa pair of ports of a three-way coupler 1206. A third port of the coupler1206 couples to the hollow tube 404.

Shafts of the valves 1204A-1204B can be coupled to and decoupled from apair of rotatable receiving elements 418. The modular valve subassembly1201 is replaceable. After being used, the modular valve subassembly1201 is dismounted from the interface base with shafts of the usedvalves 1204A-1204B being decoupled from the rotatable receiving elements418. Similarly, shafts of new unused valves 1204A-1204B may be coupledto the rotatable receiving elements 418 when mounting a new modularvalve subassembly to the interface base.

Coil springs may be wrapped around the shafts of the valves 1204A-1204Band coupled to the pair of rotatable receiving elements 418 in order tospring load the valves 1204A-1204B to automatically close so thatneither suction nor irrigation are activated when the instrument housingis not mounted onto the robotic arm, or modular valve subassembly is notmounted to the interface base 412 in the mountable housing 401.

The hollow tube 404 is supported by the interface base. A bushing 1202may be inserted over the hollow tube 404 and pressed into the collar1102 of the interface base 412.

The printed circuit board 425 may also be mounted to the interface base412. Electrical pins 424 may couple to the printed circuit board 425 toprovide an electrical connection to the adaptor 228. The integratedcircuit 426 is mounted to the printed circuit board. may be reprogrammedto indicate that the tool 1200 has been re-sterilized and its componentsreplaced.

In order to reuse the IAB robotic surgical tool 1200, the modular valvesubassembly 1201 and the coupling hoses 1208A-1208B are removed anddiscarded. A new valve subassembly 1201 and new hoses 1208A-1208B areinstalled and mounted in the robotic surgical tool. The remainingcomponents including the interface base 412, the three-way coupler 1206and the hollow tube 404 are re-sterilized prior to fitting a new modularvalve subassembly 1201 and new hoses 1208A-1208B.

After re-sterilization, the integrated circuit 426 may be programmed toindicate that the tool 1200 has been re-sterilized and its componentsreplaced.

Referring now to FIGS. 13A-13B, an IAB robotic surgical tool 1300 tocontrol the flow of fluids into and out from a surgical site isillustrated. FIG. 13A illustrates the IAB robotic surgical tool 1300with its cover removed to show that the IAB robotic surgical tool 1300includes a flow control system that utilizes rotatable pinch valves1304A-1304B.

To control the flow of fluids through the robotic surgical tool 1300, apair of flexible coupling hoses 1302A-1302B are coupled to a pair ofhose fittings 410A-410B at a first end and a pair of ports of athree-way coupler 1206 at a second end. The third port of the three-waycoupler 1206 is coupled to the proximal end of the hollow tubing 404. Topinch off hoses 1302A-1302B, the tool 1300 includes a rotatable pinchvalves 1304A-1304B rotatably mounted to the interface base 412. Each ofthe pinch valves 1304A-1304B is coupled to a rotatable receiving element418. As discussed previously, the rotatable receiving element 418 maycouple to a rotatable driver 234.

Each of the rotatable pinch valves 1304A-1304B may include a coil spring1306, a rotatable pinch arm 1320, a pinch wheel 1322 coupled to the endof the rotatable pinch arm 1320, a tab 1324, and a handle 1330. In FIG.13A, the pinch valve 1304A is illustrated as being open and allowing theflow of fluid through the tool 1300. Rotatable pinch valve 1304B isillustrated as being closed to pinch off hose 1302B at a pinch point1302B.

At a pinch point 1302W, a pinch wheel 1322 presses the hose 1302Bagainst the backstop 1315B of bulkhead 1310. The hose 1302B collapses toa diameter of zero so that no fluid can flow through it at the pinchpoint 1302B′. The rotatable pinch valve 1304A may utilize the backstop1315A of bulkhead 1310 to close and pinch off hose 1302A. The operationof a rotatable pinch valve is further discussed herein with reference toFIG. 10A. When being opened from the dosed position, the tab 1324 may beused to limit the rotation of each rotatable pinch valve 1304A-1304B toa stop 1325.

In order to readily collapse and pinch off the flow of fluids, the hoses1302A-1302B may be silicon hoses that are flexible with the capabilityof expanding to an open non-collapsed diameter from a collapsed state atthe pinch point in response to opening the rotatable pinch valves. Thepinch wheel 1322 rotates along the hose as its being pinched off so asto avoid damaging the hose and cause leeks.

The coil spring 1306 wrapped around the shafts of the pinch valves1304A-1304B may be used to spring load the valves 1204A-1204B toautomatically close and pinch off the hoses 1302A-1302B when theinstrument housing is dismounted from the robotic arm or otherwise notbeing actuated.

While the IAB robotic surgical tool 1300 is typically under control ofthe master control console 150, the handles 1330A-1330B allow for manualuse of the IAB robot surgical tool 1300 when it is not mounted to arobotic arm. The handles 1330A-1330B are respectively coupled to theshafts 1330A-1330B of the rotatable pinch valves 1304A-1304B in order tomanually rotate them open and closed by hand. When the IAB robotsurgical tool 1300 is not mounted to a robotic arm so that the rotatablereceiving elements 418 are not engaged with the rotatable drivers 234,the assistant surgeon or nurse may manually operate the IAB roboticsurgical tool 1300 to control the fluid flows by using the handles1330A-1330B. Furthermore, the handles 1330A-1330B allow for cleaning theflow control system as is described further below.

Referring now to FIG. 13B, the IAB robotic surgical tool 1300 isillustrated with its cover 1350 coupled to the interface base 412. Thecover 1350 provides protection to the flow control system 417 includingthe rotatable pinch valves in the hoses. The handles 1330A-1330B extendthrough the cover 1350 so that they are accessible to manually controlthe pinch valves.

Additionally, the handle 1330A includes a clip 1332 that may be swungaround and fitted into a groove 1334 of the handle 1305B. With the clip1332 within the groove 1334, both handles 1330A-1330B are open such thatneither hose 1302A nor hose 1302B is pinched closed. The handles areclipped together in the open position during a cleaning of the flowcontrol system of the robotic surgical tool 1300 and to ease replacementof the hoses.

To clip the handles together, the handle is rotated to the open positionand the clip 1332 is swung to position 1332′. The handle 1330B isrotated to position 1330B′ so that the clip 1332′ may be inserted intoits groove 1334. In this position, the pinch valves are both open andthe hoses 1302A-1302B are not pinched off but are open so that they canbe cleaned.

Referring now to FIG. 14, a top view of a IAB robotic surgical tool 1400is illustrated with its cover removed to show the pinch valves andreplaceable tubing. The tool 1400 is substantially similar to tool 1300previously described but for use of the coupling hoses 1302A-1302B tocontrol the flow of fluids within the tool. Tool 1400 eliminates thehose fittings 410A-410B and the short coupling hoses 1302A-1302B betweenthe hose fittings 410A-410B and the three-way coupler 1206. Instead, thetool 1400 includes replaceable hoses 1106B-106A directly coupled to theports of the three-way coupler 1206, as is illustrated in FIG. 14. Thereplaceable hoses 106B-106A extend beyond the robotic surgical tool inorder to couple externally to sources of fluids.

In contrast, the coupling hoses 1302A-1302B of the tool 1300 requirecleaning and sterilization after each use of the tool 1300 in order forit to be reused. In tool 1400, the hoses 106A-106B are not cleaned, butreplaced after each usage with new sterile hoses so that the tool 1400may be reused. With the rotatable pinch valves open, the interface base412 is formed with bulkhead 1410 to allow the hoses 106A-106B to bereadily replaceable and coupled to the three-way coupled 1206.

The tool 1400 includes the rotatable pinch valves 1304A-1304B with theirpinch arms 1320 and pinch rollers 1322 coupled thereto to pinch off thehoses 106A-106B and stop the flow of fluids. The rotatable pinch valvesare rotatably mounted to the interface base 412. The shaft of eachrotatable valve is coupled to the rotatable receiving element 418.

In FIG. 14, rotatable pinch valve 1304A is open such that hose 106A mayallow a fluid to flow therein. Rotatable pinch valve 1304B is closed topinch off hose 106B at point 1402B. Thus, with pinch valve 1304B closed,a fluid will not flow through hose 106B. Bulkhead 1410 is provided sothat the hoses 106A-106B may be readily replaced when the rotatablepinch valves 1304A-1304B are held in their open positions. The bulkhead1410 includes backstops 1415A and 1415B against which the rotatablepinch valves 1304A-1304B may pinch off the respective hoses 106A-106B.1-loses 106A-106B may be formed of a silicon rubber compound so thatthey are flexible and can be readily collapsed and expanded in responseto the opening and closing of the rotatable pinch valves.

As discussed previously, the replaceable hoses 106B-106A are directlycoupled to two of the three ports of the three-way coupler 1206. Thethird port of the three-way coupler 1206 is coupled to the proximal endof the hollow tube 404. The hollow tube 404 may be further supported bythe interface base 412 by inserting a the hollow tube into a bushingmounted in the collar 1102.

The IAB robotic surgical tools, including tool 1400, may further includethe printed circuit board 425 with one or more pins 424 and one or moreinterrelated circuits 426 coupled thereto to indicate its tool type,whether its new or refurbished, and if refurbished, the number of prioruses.

Referring now to FIGS. 15A-15B, IAB robotic surgical tools 1500A-1500Bare respectively illustrated without their covers. The tools 1500A-1500Bdo not internally control the flow of fluids into and out of a surgicalsite. Instead, the control of the flow of fluids into and out of asurgical site is externally controlled away from the surgical tool. Aspreviously discussed with reference to FIG. 1, the control of fluids maybe provided at the respective fluid pumps by the computer system 151 inthe surgeons master control console 150 under the control of theoperator O.

Even though fluid flow is externally controlled, the IAB roboticsurgical tools 1500A-1500B are mounted to a robotic arm of the roboticsurgical manipulator 152 and can facilitate the flow of fluids into andout of a surgical site through couplers and the hollow tube 404.

In FIG. 15A, the IAB robotic surgical tool 1500A, includes a three-waycoupler 1206 mounted to the interface base 412. A proximal end of thehollow tube 404 couples to a first port of the three-way coupler 1206.Replaceable hoses 106A-106B respectively couple to a second and a thirdport of the three-way coupler 1206. The tool 1500A may further includethe printed circuit board 425 with the electrical pins 424 in one ormore interrelated circuits 426 coupled thereto to indicate the tool typeand that external fluid control is to be utilized.

In FIG. 15B, the IAB robotic surgical tool 1500B includes a four-waycoupler 1506 with a first port coupled to the hollow tube 404, a secondport coupled to an end of a first hose 106A, a third port coupled to anend of a second hose 106B, and a fourth port coupled to an end of athird hose 106C. Tool 1500E may also include the printed circuit board425 with the electrical pins 424 and the one or more integrated circuits426 coupled thereto to indicate the tool type and that external fluidcontrol is to be utilized to control the flow of fluids flow in thehoses 106A-106C.

Cleaning and sterilization of the IAB robotic surgical tools 1500A-1500Bis fairly easy as there are no valves. To reuse the tools 1500A-1500B,used hoses 106A-106C are removed. The remaining portions of the tools1500A and 1500B, such as the couplers and the hollow tube 404, are thensterilized and then fitted with new sterile hoses 106A-106C so that theymay be reused.

While IAB robotic surgical tools 1500A-1500B have been shown anddescribed to include couplers 1206, 1506, respectively, the couplers canbe removed and provided externally to the surgical tools 1500A-1500B. Inwhich case, a single hose would be routed from the external coupler tothe IAB robotic surgical tool. The single hose may couple to a hosefitting, that in turn would be coupled to the hollow tube 404.Alternatively, the proximal end of the hollow tube could be formed as ahose fitting and directly couple to an end of the hose. In this manner,reuse of the IAB robotic surgical tool may further simplified with fewercomponents to sterilize and a single hose to replace.

User Control

Typically, irrigation and aspiration of a surgical site are manuallycontrolled by an assisting surgeon or nurse using manual surgical tools.By allowing tele-operated or remote control and actuation of an IA orIAB robotic surgical instrument, the primary surgeon can now controlirrigation and aspiration of a surgical site.

The flow control system of the IAB robotic surgical instrument may becontrolled by the operator O seated at the robotic surgical mastercontrol console 1150 in a number of ways. For example, master axes ofmovement in a control handle that is normally used for controlling awristed robotic surgical instrument may be used to activate irrigation,aspiration, and or blowing through an IAB robotic surgical instrumentover a surgical site. As previously discussed, one or a combination ofboth the rotational motion of the touch sensitive handle 325 and thesqueezing motion of the grips 350A, 350B may be used to control the flowof fluids through the IAB robotic surgical tools. For example, therotational motion of the touch sensitive handle 325 may be used for thecontrol of irrigation while the squeezing motion of the grips 350A, 350Bmay be used for controlling suction in a surgical site.

FIG. 16A is a side view of the touch sensitive handle 325 of the roboticsurgical master control console 150. The touch sensitive handle 325 maybe used by the operator O to control the fluid flow in IAB roboticsurgical instruments. In one embodiment of the invention, a rotationalmotion R (“roll”) of the touch sensitive handle may control theirrigation, aspiration, and/or blowing through IAB surgical instruments101A, 400. For example, the handle may rotated clockwise to open a firstvalve to have a fluid flow through the IAB surgical instrument into orout of a surgical site. The handle may then be rotated counter-clockwiseto close the first valve and stop the flow of fluid through the IABsurgical instrument and into or out of the surgical site. A centerdetent point D of rotation in the touch sensitive handle 325 may be usedto switch over from one type of fluid flow to another. In which case,the handle may rotated counter-clockwise to open a second valve orswitch open the first valve to a different position to have a secondfluid flow through the IAB surgical instrument and into or out of asurgical site. The handle 325 may then be rotated clockwise to thecenter detent point D to close the second valve and stop the flow offluid through the IAB surgical instrument and into or out of thesurgical site.

The rotational motion of the handle 325 may typically control wristmotors in the robotic surgical manipulator 152 to control a wrist motionof a robotic surgical tool. In this case, the wrist motors in therobotic surgical manipulator 152 may be adapted for use to control oneor move valves in the IAB robotic surgical instruments in response tothe rotational motion of the handle 325.

In another embodiment of the invention, a gripping or squeezing motion(“master grip”) on the grips 350A-350B of the touch sensitive handle 325may be used to control the flow of fluids through IAB robotic surgicalinstruments. For example, squeezing the grip of touch sensitive handlemay be used to turn on the suction of the I/A/B surgical instrument andthe grip released to turn off the suction. In which case, the touchsensitive handle may include one or more springs 306A-306C to providediffering spring constants or a single spring 306 with a progressiverate spring constant as the positions of the grips 350A-350B change. Aexplanation as to how the touch sensitive handle 325 functions waspreviously describe with reference to FIG. 3C. By using the grip of thetouch sensitive handle 325 to control the IAB robotic surgicalinstrument, the rotational motion of the handle may be used for furthermovement or control of the instrument.

The position of the grips 350A-350B can vary over a range of positionsin order to control suction, blowing and irrigation of a surgical sitesuch as from a fully released or fully open position to a fully squeezedor fully closed position.

FIGS. 116B-16D illustrate different positions of the grips 350A-350B ofthe touch sensitive handle 325 when squeezed by a hand H of the operatorO to control the IAB robotic surgical tool at a surgical site. FIG. 16Billustrates a fully open grip position without any squeezing by the handH. FIG. 16C illustrates the hand H squeezing the grips 350A-350B to ahalf-way closed position. To provide force feedback to a user, a firstspring rate may be used over a range of positions, such as from thefully open to the half-way closed position. FIG. 16D illustrates thehand H squeezing the grips 350A-350B to a fully closed position. Toprovide force feedback to a user, a second spring rate somewhat greaterthan the first may be used over a range of positions, such as from thehalf-way closed position to the fully closed position.

FIG. 17 is a graph showing exemplary control of irrigation andaspiration using the grip control of the touch sensitive handle 325. Theopen, half, and closed positions along the X-axis of the graphcorrespond to the different positions of the grips 350A-350B of thetouch sensitive handle 325 illustrated in FIGS. 16B-16D. Curve 1701illustrates a flow of vacuum or a percentage of suction. Curve 1710illustrates a flow of irrigation fluid through the tool and into asurgical site.

With the grips 350A-350B in the fully released or fully open position,both suction and irrigation are turned off. As the grip is initiallysqueezed, suction is turned on and irrigation remains turned off. As thegrip position changes from fully-open to half-way closed, curve 1701illustrates the flow of vacuum change from zero to one hundred percent.As the grip reaches half way, suction may be fully turned on with anegligible amount of irrigation. As the operator O squeezes furtherstill, past the half-way closed position, the vacuum flow tapers offtoward zero and the irrigation begins from zero around the three-fourthsclosed position, as is illustrated by curves 1701 and 1710.

In another embodiment of the invention, both the rotational motion ofthe touch sensitive handle 325 and the squeezing motion of the grips350A, 350B may be used to control the flow of fluids through the IABrobotic surgical tools.

In addition to the touch sensitive handle 325 and its grips 350A-350B,foot pedals 318 of the surgeons master control console 150, asillustrated in FIG. 3A, may be used to further control the IAB roboticsurgical tools. For example, one of the foot pedals 318 may be used toswitch from suction control to blow control in order to blow apressurized gas over the surgical site. In which case, a grippingsqueezing motion of the touch sensitive handle can also control theblowing provided by the I/A/B surgical instrument.

Alternatively, the touch sensitive handle 325 may be modified to includebuttons to activate irrigation, aspiration, and or blowing when an IABrobotic surgical tool is mounted to the robotic surgical manipulator 152

To avoid using a touch sensitive handle, the foot pedals 318 of thesurgeons master control console 150 may be used to fully control thesuction and irrigation provided by an IAB robotic surgical tool. In oneembodiment of the invention, a first foot pedal 318A may be used tocontrol suction and a second foot pedal 318B may be used to control theirrigation provided by an IA or IAB surgical instrument.

With knowledge of other surgical instruments that are to be controlledby some of the foot pedals, foot pedals on the right side of thefootrest may be used, for example. Two pedals and a toggle switch on themaster control console or the control handle may be used to control avariety of actuations in a plurality of surgical instruments knowing thecontext of the robotic surgical system in advance. Additionally, footpedals normally used for cautery (or another energy device) may beswitched to activate irrigation, aspiration, and or blowing when an IABrobotic surgical tool is mounted to the robotic surgical manipulator152.

To avoid any use of hands or feet in controlling the I/A surgicalinstrument, voice activation may be used to activate irrigation,aspiration, and or blowing when an IAB robotic surgical tool is mountedto the robotic surgical manipulator 152. In this case, an operator'svoice or speech may be used to control the suction, irrigation, and orblowing provided by an IA or IAB surgical instrument. For example,spoken voice commands such as “suction ON”, “suction OFF”, “suctionlightly”, “irrigation ON”, “irrigation OFF”, and “irrigate lightly” maybe used to control the suction and irrigation provided by the IA or IABsurgical instrument.

To recognize the voice commands, the master control console 150 includesa microphone 315 and a speech recognizer 317. The speech recognizer 317may generate the control signals that are provided to the IA or IABsurgical instrument.

While various control means have been individually described here, twoor more of these control means may be combined in order to control theflow of fluids through an IAB robotic surgical tool. For example, therotational motion of the touch sensitive handle 325 may be used for thecontrol of irrigation while the squeezing motion of the grips 350A, 350Bmay be used for controlling suction in a surgical site.

User Feedback

Within a surgical site it may be difficult to determine if a valve isopen and providing suction, blowing, or irrigation. User feedback may beprovided to the surgeon at the console to provide information to him/hersuch as suction is on and at what level—high, medium, low, or otherwiseoff. User feedback information may also be provided regarding blowingand irrigation—whether its off or on, and if on at what level—high,medium, or low. However, it typically is easier to visually determinewhen a liquid is flowing for irrigation than when suction is providedfor aspiration or a pressurized gas for blowing.

Referring now to FIGS. 18A-18G, various types of user feedback may beprovided to the IAB robotic surgical tools.

In FIG. 18A, the irrigation/aspiration/blowing robotic surgical tool400A includes a pair of light emitting diodes (LEDs) 1801-1802 near thetip 406 of the hollow tube 404 in order provide visible feedback to anoperator O that a fluid is flowing through the tool. One or more wires1804 may couple between the light emitting diodes 1801-1802 and theprinted circuit board 425 within the mountable housing 401. Electricalsignals can be transmitted towards the light emitting diodes from theprinted circuit board to turn them on during the flow of fluids and offwhen no fluid flow occurs. The integrated circuit 426 may generate theelectrical signals to control the light emitting diodes. In this manner,the light emitting diode 1801-1802 may be activated by control signalsreceived over the one or more wires 1804 from the master control console150. Additional light emitting diodes may be provided near the tip 406of the hollow tube 404 in order provide additional visible feedback foradditional fluid flows. Moreover, the light emitting diodes 1801-1802,including any additional LEDs, may emit photons of different wavelengthsin order that different colors can be provided corresponding todifferent types of fluid flow (e.g., suction, irrigation, gas pressure

In FIG. 18B, the IAB robotic surgical tool 400B includes a light pipe1812 mounted externally to the hollow tube 404 to provide visible userfeedback to the operator O that fluids are flowing into or out of thesurgical site. The light pipe 1812 maybe a side lighting fiber opticcable with one end optically coupled to one or more light emittingdiodes 1811 to receive photons. The light emitting diodes 1811 may emitphotons of different wavelengths in order that different colors can beprovided corresponding to different types of fluid flow (e.g., suction,irrigation, gas pressure). One or more wires 1814 may couple between theone or more light emitting diodes 1811 and the printed circuit board 425mounted within the housing 401. An integrated circuit, such asintegrated circuit 426, may be used to drive the one or more lightemitting diodes 1811 to turn them on or off. Alternatively when fluidsflow, the one or more light emitting diodes 1811 may be activateddirectly by control signals received over the one or more wires 1814from the master control console 150 or from the integrated circuit 426.More than one light pipe 1812 may be provide along the circumference ofthe hollow tube 404 so that the side light may be visible at differentviewing angles and positions of the IAB robotic surgical instrument.

in comparison with the light emitting diodes 1801-1802 at the tip, thelight pipe 1812 provides a light that maybe visible along the entirelength of the hollow tube 404 so that it can be seen, regardless of theposition of the tip. Additionally, the light emitting diode 1811 isprotected under the cover of the mountable housing 401.

Referring now to FIG. 18C, an IAB robotic surgical tool 400C isillustrated. In tools 400A-400B previously described, user feedback wasprovided by electro-optic means. In contrast, the user feedback providedby the tool 400C is provided mechanically. The IAB robotic surgical tool400C includes a sliding sleeve 1820 and a visible scale 1824 coupled tothe hollow tube 404. The sliding sleeve 1820 is coaxial with the hollowtube 404 and covers over the scale 1824 when no fluid is flowing throughthe tool. The sliding sleeve 1820 can be slid along the hollow tube 404and into the housing 401 to reveal the visible scale 1824 as fluids flowthrough the tool 400C. The visible scale 1824 maybe different coloredbands to indicate the level of fluid flow within the tool 400C.Alternatively, the visible scale 1824 maybe bands of different thicknessto reveal the amount of fluid flow within the tool 400C. The slidingsleeve 1820 can be gradually received into the hosing 401 to reveal theappropriate scale in proportion to the amount of fluid flow in the tool400C.

Without any flow of fluids within the tool 400C, a tip 1822 of thesliding sleeve 1820 may completely cover over the visible scale 1824.With maximum fluid flow in the tool 400C, the sliding sleeve 1820 may beslid into the housing 401 such that its tip moves to a position 1822′ tofully reveal the visible scale 1824. The opposite end 1823 of thesliding sleeve 1820 moves inward to position 1823′. In this manner, thelevel of fluid flow in the tool 400C maybe provided to a user bymechanical means.

The sliding sleeve 1820 may be pulled into the housing 401 and pushedback out in a variety of ways. A spring may used to apply a forceagainst the retraction of the sliding sleeve 1820 into the housing sothat it can push it back out after the pulling force is released. Acable with one end coupled to and wrapped around a take up drum may becoupled to the sleeve 1820 through a pulley in order to pull the sleeveinto the housing 401. A gearing system may alternatively be used. Apinion gear may couple to a rotatable receiving element 418 and to arack coupled to the sleeve 1820. Alternatively, a ball screw and a leadscrew may be used. A slider with a crank or lever arm may be used. Anelectrical means may also be used, such as a solenoid to pull in on thesliding sleeve 1820.

Referring now to FIGS. 18D-18G, an IAB robotic surgical tool 400Dincludes another mechanical structure to provide user feedback. Howeverinstead of a sliding sleeve, the IAB robotic surgical tool 400D includesa rotating sleeve 1820′ coaxial with the hollow tube 404. FIGS. 18E-18Gillustrate various types of tips 406 and sleeves 1820A′-1820C′ that maybe used to provide user feedback.

In FIG. 18D, the IAB robotic surgical tool 400D includes the hollow tubecoupled to the solid valve body 1101, 1101′ mounted to the interfacebase 412. The tool 400D further includes the hollow rotatable sleeve1820′ coaxial around the hollow tube 404. The rotatable sleeve 1820′couples to a bearing assembly 1852 mounted to the collar 1102 torotatably mount to the interface base 412.

For rotational purposes, the rotatable sleeve 1820′ includes a drum 1854that extends from the bearing assembly 1852 into the housing 401. Thereare a number of ways to couple a rotational movement from the surgicalmanipulator to the rotatable sleeve 1820′. In one embodiment of theinvention, the tool 400D is backward compatible and includes a spool.1830 rotatably mounted to the interface base 412. A rotatable receivingelement 418 of the IAB robotic surgical tool is coupled to the spool1830. For robotic control from the master control console 150, therotatable receiving element 418 couples to the rotatable driver 234 bymeans of the pins 422A-422B within the openings 240A-240B, respectively.

Coupled between the spool 1830 and the drum 1854 of the rotatable sleeveare a top cable 1832 and a bottom cable 1834. One end of each cablecouples to the spool 1830. The opposite end of each cable couples to thedrum 2854. Alternatively, a single cable may be used by appropriatelywrapping it around the drum 2834 and the spool 1830. The top cable andthe bottom cable wrap different from each other around the spool. Theyalso wrap different from each other around the drum 1854. In thismanner, one cable is being let out while the other cable is being takenin by the rotation of the spool. 1854. If the spool 1854 is turningclockwise as indicated by arrow F2, the cable 1832 is taken in, thecable 1834 is let out, and the sleeve 1820′ rotates counter clockwise asillustrated by the letter G2. If the spool 1854 is turningcounter-clockwise as indicated by arrow F1, the cable 1832 is let out,the cable 1834 is let out, and the sleeve 1820′ rotates clockwise asillustrated by the letter G1.

There rotational movement of the receiving element 418 may betransmitted by other means to the rotatable sleeve 1820′. For example, agear system may be used. In which case, a first worm gear may be used inplace of the spool 1830 and a second worm gear coupling to the first maybe used in place of the drum 1854.

The flow control system provided by the solid valve bodies 1101, 1101′and their valves was previously described with reference to FIGS.11A-11E and is incorporated here by reference.

Referring now to FIG. 18E, the hollow rotatable sleeve 1820A′ includes aplurality of narrow openings 1840 located around a circumference of adistal end of the sleeve 1820A′. This way, the scale may be seen fromdifferent angles. The narrow window openings 1840 may be oval shaped asillustrated or rectangularly shaped. The hollow tube 404 includes aplurality of curved color stripes 1842 around its circumference that maybe rectangularly shaped as illustrated by the dashed lines in FIG. 18E.As the sleeve 1820A′ rotates, the stripes 1842 are positioned on thehollow tube 404 to be substantially aligned with the window openings1840.

In one position of the sleeve 1820A′, no color stripe or a color striperepresentative of fluid flow being completely shut off is located withina window opening 1840. This corresponds to all the valves being closedto shut off the fluid flow through the IAB robotic surgical tool.Rotating the sleeve 1820A′ from a shut off position, a first or secondcolor stripe may begin to be revealed, such as illustrated in FIGS.18E-18G, representative of a first fluid flow in an IAB robotic surgicalinstrument. The level of fluid flow can be indicated by the amount ofcolor stripe 1842 that is exposed in the window opening 1840. With thecolor stripe 1842 being completely exposed by the window opening 1840,the corresponding valve of the flow control system may be fully open.With the sleeve 1820A′ being rotated still further, a second or thirdcolor stripe may begin to be exposed by the window opening 1840. Inwhich case, the prior fluid flow may be substantially shut off andanother valve opened to allow another fluid to flow through the IABrobotic surgical tool.

The different color stripes 1842 indicate the flow of different fluidsthrough the IAB robotic surgical. For example, a red color stripe mayindicate that all fluid flows are fully shut off. A green color stripemay indicate pressurized gas flow. A blue color stripe may indicateirrigation. An orange color stripe may indicate suction or aspiration.

Referring now to FIG. 18F, the tool 400D includes the rotatable sleeve1820B′ that is similar to the rotatable sleeve 1820A′ but has triangularshaped window openings 1850 instead. The hollow tube 404 includes theplurality of color stripes 1842. But for the shape of the windowopenings, the sleeve 11820′B operates substantially similar to that ofsleeve 1820A′ described previously.

Referring now to FIG. 18G, the hollow rotatable sleeve 1820C′ includes aplurality of narrow rectangular openings 1860 located around acircumference of a distal end. With the plurality of openings 1860, thescale may be seen from different angles and positions of the tool. Thenarrow window openings 1860 are rectangularly shaped. However, thehollow tube 404 includes a plurality of triangle stripes 1842 curvingaround its circumference as illustrated by the dashed lines in FIG. 18G.The colored triangle stripes 1862 are positioned on the hollow tube 404to be substantially aligned with the window openings 186, as the sleeve1820C′ rotates,

As the sleeve 1820C′ rotates, the level of fluid flow can be indicatedby the amount of color triangular stripe 1862 that is exposed in thewindow opening 1860. As discussed previously, the type of fluid flow maybe indicated by the different colors.

The type of user feedback previously disclosed was implemented by theIAB robotic surgical tool. Alternatively, user feedback may be providedby the master control console 150, such as through an electronic visualdisplay of a graphical icon or image.

Referring now to FIG. 19, a simulated 3D image of a surgical site in aviewer 312 of the master control console 150 is illustrated when theoperators eyes are in the viewer 312. As illustrated in FIGS. 20A-20B,stereo optic images of a left image 1900L and a right image 1900R areprovided at the viewer 312, in order to provide a three-dimensionalimage when viewed by the operator O. In the left and right views, theIAB robotic surgical tool 400 is located within the surgical site. Toprovide user feedback as to the fluid flow in the tool 400, icons 1902are overlaid onto the images displayed in one or both of the displays1900L, 1900R. The icons may use different colors overlaid on the imagein order to display the function of the tool 400. A scale maybe providedin the viewer to display the level of the fluid flow in the tool 400.Alternatively abbreviated letters maybe used to indicate the type offluid flow (e. S-suction or A-aspiration, I-irrigation, B-blowing) inthe tool 400 as well as its level, such as L, M, and H.

Referring now to FIG. 20A, a viewer 312A of the master control console150 is illustrated. To provide a three-dimensional perspective, theviewer 312A includes stereo images for each eye including left image400L of the tool 400 and surgical site and a right image 400R of thetool 400 and surgical site. One or more icons 2010R may be overlaid ontothe images in the right viewfinder 2001R to indicate the functionalityand the level of fluid flow in the IAB robotic surgical tool 400. Theimages 400R and 400L in the viewfinders maybe provided by a right liquidcrystal display 2002R and a left liquid crystal display 2002L,respectively.

As the one or more icons 2010R in the viewer 312A are provided in asingle viewfinder of the stereo viewer, they are displayed astwo-dimensional icons. However, three dimensional images of the iconsmaybe provided and overlaid onto stereo left and right images of thesurgical site.

In FIG. 20B, one or more icons to provide user feedback of the controlof the IAB robotic surgical tool are overlaid onto both the left image400L and right image 400R of the surgical site. In the right viewfinder2001R, a right icon image 2010R is overlaid onto the right image 400Rbeing displayed by the liquid crystal display 2002R. In the leftviewfinder 2001L, a left icon image 2010L is overlaid onto the leftimage 400L of the surgical site provided by the liquid crystal display2002L. In this manner, a stereo image of the icons may be used toprovide user feedback of the control of the IAB robotic surgical toolmaybe provided in the viewer 312B.

Exemplary Operation of the IAB Robotic Surgical Instruments

In order to use the IAB robotic surgical tools, it is first undergoes aninitial setup prior to surgery. The IAB robotic surgical instrument ismounted to a robotic arm 153 of the robotic surgical manipulator 152.One or more hoses 160A-160C are coupled from the IAB robotic surgicalinstrument to one or more pumps 102A-102C. The robotic surgicalmanipulator 152 is oriented with the patient P so that the tip of thehollow tube of the irrigation-aspiration robotic surgical instrument maybe inserted into the patient near the desired surgical site. During thesurgery, the operator O may control the flow of fluids between thesurgical site and the IAB robotic surgical instrument from the mastercontrol console 150 using the flow control system 417 of the IAB roboticsurgical tool. Alternatively or conjunctively, the operator may alsocontrol the flow of fluids between the IAB robotic surgical instrumentand the one or more pumps. To control the flow of fluids, the operator Oat the master control console 150 may generate one or more controlsignals to control the IAB robotic surgical instrument. The one or morecontrol signals may be directly or indirectly coupled into the IABrobotic surgical instrument. For example, the one or more controlsignals may be electrical signals that are directly coupled into the IABrobotic surgical instrument to electrically control one or more valves.Alternatively, the one or more control signals may be electrical signalsthat are translated into a mechanical motion. In this case, themechanical motion may be directly coupled into IAB robotic surgicalinstrument while the electrical control signals are indirectly coupledinto the IAB robotic surgical instrument. In any case, one or morevalves in the IAB robotic surgical instrument may be opened to flow oneor more fluids over a surgical site in response to the control signals.Similarly, one or more valves in the IAB robotic surgical instrument maybe closed to reduce the flow of the one or more fluids over the surgicalsite in response to the control signals.

In alternative embodiments of the invention, the control of the flow offluids between the surgical site and the IAB robotic surgical instrumentis provided by controlling the one or more pumps. In which case, thecontrol signals are coupled to the pumps and/or flow control valveslocated external to the IAB robotic surgical instrument. The IAB roboticsurgical instrument may include a coupler to couple between the hosesfrom the one or more pumps and the hollow tube that is inserted into apatient.

The one or more control signals may be generated in various waysincluding in response to movement of a touch sensitive handle of amaster control console, squeezing of a grip of the touch sensitivehandle, rotation of the touch sensitive handle, movement of a footpedal, or a spoken command at the master control console.

The level of flow of the fluids and the control thereof may be monitoredbetween the surgical site and the IAB robotic surgical instrumentthrough the user-feedback means previously described. One user-feedbackmeans is one or more light emitting diodes coupled near the tip of thehollow tube of the IAB robotic surgical instrument. The one or morelight emitting diodes generate a visible light in response to thecontrol of a flow of a fluid through the IAB robotic surgicalinstrument. Another user-feedback means is a light pipe coupled alongthe length of the hollow tube of the irrigation-aspiration roboticsurgical instrument with a light emitting diode. The light emittingdiode couples photons into the light pipe and generates a visible sidelight in response to the control of a flow of a fluid through theirrigation-aspiration robotic surgical instrument. Still anotheruser-feedback means is a sliding sleeve coaxial with the hollow tube anda scale coupled to the irrigation-aspiration robotic surgicalinstrument. The sliding sleeve slides along the hollow tube and revealsthe scale in response to the control of a flow of a fluid through theirrigation-aspiration robotic surgical instrument.

After the using the IAB robotic surgical instrument, it is removed fromthe patient and can then be dismounted from the robotic arm of therobotic surgical manipulator 152. If the IAB robotic surgical instrumentis to be reused, a modular valve assembly and one or more hoses of theirrigation-aspiration robotic surgical instrument may be discarded andthe remaining components of the IAB robotic surgical instrumentsterilized for reuse. In the case that the IAB robotic surgicalinstrument includes a flow control system with an inexpensive valvesubassembly, the irrigation-aspiration robotic surgical instrument canbe removed from the patient; dismounted from the robotic arm; and thendiscarded.

While certain exemplary embodiments of the invention have been describedand shown in the accompanying drawings, it is to be understood that suchembodiments are merely illustrative of and not restrictive on the broadinvention, and that the embodiments of the invention not be limited tothe specific constructions and arrangements shown and described, sincevarious other modifications may occur to those ordinarily skilled in theart. For example, while an irrigation/aspiration/blowing roboticsurgical instrument has been shown and described in a number ofembodiments of the invention, it may be modified into an irrigationrobotic surgical instrument with a single valve to provide irrigationonly or it may be modified into an aspiration robotic surgicalinstrument with a single valve to provide aspiration only. Furthermore,while aspiration or suction has been described as being provided by avacuum pump, one would recognize that a pressurized gas maybe providedinstead, such as air by an air pump. The pressurized gas may be used toblow debris or cut tissue, if sufficient pressure is provided. Rather,the embodiments of the invention should be construed according to theclaims that follow below,

1-20. (canceled)
 21. A surgical instrument, comprising: a housing; and avalve mounted in the housing; wherein the valve is configured to controla flow of a fluid into or out of a surgical site in response to either arobotic actuation of the valve or a manual actuation of the valve;wherein the valve comprises: a valve shaft, a receiving memberstructurally coupled to the valve shaft, and a manual actuationcomponent structurally coupled to the valve shaft and extending from thehousing; wherein the receiving member is configured to releasably coupleto a driver of a robotic manipulator to receive the robotic actuationfrom the driver remotely controlled by a surgeon to adjust a state ofthe valve; and wherein the manual actuation component is configured toreceive the manual actuation to adjust the state of the valve.
 22. Thesurgical instrument of claim 21, wherein the robotic actuation of thevalve and the manual actuation of the valve both adjust the state of thevalve in a same manner.
 23. The surgical instrument of claim 21 furthercomprising: a fluid channel, wherein the valve is positioned to controlfluid flow within the fluid channel.
 24. The surgical instrument ofclaim 21, wherein rotation of the receiving member causes the valveshaft to control fluid flow by rotating to a first position to open thevalve and to a second position to close the valve.
 25. The surgicalinstrument of claim 21, wherein the valve comprises a pinion gearcoupled to the valve shaft.
 26. The surgical instrument of claim 21,wherein the robotic actuation comprises a rotary motion.
 27. Thesurgical instrument of claim 21, wherein the manual actuation comprisesa rotary motion.
 28. The surgical instrument of claim 21, wherein thevalve comprises at least one of an electrically operated valve and amagnetically operated valve.
 29. The surgical instrument of claim 21:wherein the receiving member is a rotatable receiving member; andwherein the driver is a rotatable driver.
 30. The surgical instrument ofclaim 29, wherein the rotatable receiving member comprises: a pluralityof inner pins that align with a first opening of the rotatable driver;and a plurality of outer pins that align with a second opening of therotatable driver.
 31. The surgical instrument of claim 21: wherein thevalve shaft is a cylindrical shaft comprising a flow channel; andwherein the surgical instrument further comprises a seal wrapped aroundthe cylindrical shaft to seal the flow channel.
 32. The surgicalinstrument of claim 31: wherein the seal is a slanted seal; and whereinthe cylindrical shaft comprises a slanted channel to receive the sealand keep the seal in position as the valve is operated.
 33. The surgicalinstrument of claim 21, wherein the housing comprises a release lever ata side of the housing to release the surgical instrument from a roboticarm.